Clinical Guidelines For The Management Of Cutaneous Leishmaniasis In British Military Personnel

Bailey, M S; Green, AD; Ellis, C; O’Dempsey, TJ; Beeching, Nicholas J.; Lockwood, Dnj; Chionini, PL; Ad, Bryceson

doi:10.1136/jramc-151-02-03

Cited by 33 publications

(36 citation statements)

References 14 publications

(9 reference statements)

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“…The diagnosis is made from a skin biopsy of the edge of the lesion that is sent for histology and parasitology tests, which can identify the exact species involved. The choice of treatment is currently dependent on the site, size and number of lesions, whether there are features of dissemination and the species involved 27. Local treatments such as intralesional injection of sodium stibogluconate (SSG) and cryotherapy may be effective for some lesions,28 but systemic treatments such as intravenous SSG and oral miltefosine are sometimes required 27…”

Section: Tropical Skin Infectionsmentioning

confidence: 99%

Tropical skin diseases in British military personnel

Bailey

2013

J R Army Med Corps

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Skin complaints are common in travellers to foreign countries and are responsible for up to 25% of medical consultations by military personnel during deployments in the tropics. They also have relatively high rates of field hospital admission, medical evacuation and referral to UK Role 4 healthcare facilities. Non-infectious tropical skin diseases include sunburn, heat rash, arthropod bites, venomous bites, contact dermatitis and phytophotodermatitis. During tropical deployments skin infections that commonly occur in military personnel may become more frequent, severe and difficult to treat. Several systemic tropical infections have cutaneous features that can be useful in making early diagnoses. Tropical skin infections such as cutaneous larva migrans, cutaneous myiasis, cutaneous leishmaniasis and leprosy do occur in British troops and require specialist clinical management. This illustrated review focuses on the most significant tropical skin diseases that have occurred in British military personnel in recent years. Clinical management of these conditions on deployments would be improved and medical evacuations could be reduced if a military dermatology 'reach-back' service (including a telemedicine facility) was available.

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Section: Tropical Skin Infectionsmentioning

confidence: 99%

Tropical skin diseases in British military personnel

Bailey

2013

J R Army Med Corps

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“…Complex cutaneous leishmaniasis features more than four lesions, where lesion diameter is >50 mm or >1 cm in cosmetically or functionally sensitive areas such as face or joints; where there is large regional adenopathy or local subcutaneous nodules; the host is immunocompromised; and the condition is unresponsive to simple treatment 12…”

Section: Discussionmentioning

confidence: 99%

“…Monitor patients on parenteral sodium stibogluconate twice weekly with tests for full blood count, urea and electrolytes, liver function, and with electrocardiography 2. Stop treatment if there is notable change to the full blood count and urea and electrolytes, transaminitis 10-15 times above the upper limit of normal, or QTc prolongation over 500 ms 27. Advise patients to avoid alcohol and exercise for one week after treatment completion.…”

Section: Discussionmentioning

confidence: 99%

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An ulcer that will not heal

Clegg

Hall

Lockwood

2018

BMJ

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“…One small study suggests improved efficacy with adjunctive pentoxifylline (81.3 % n=26/32 vs. 50 % n=16/32) [49]. Despite poor evidence, experts endorse systemic antimonials in some national guidelines and continue to use them for complex, treatment refractory OWCL [47,98].…”

Section: Pentavalent Antimony (Sbv)mentioning

confidence: 96%

Cutaneous Leishmaniasis in Travellers: a Focus on Epidemiology and Treatment in 2015

Showler

Boggild

2015

Curr Infect Dis Rep

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Imported cutaneous leishmaniasis (CL) is a growing problem with increasing global travel to endemic areas. Returned travellers seeking care encounter significant barriers to treatment, including diagnostic delays and difficult access to anti-leishmanial drugs. Treatment recommendations in non-endemic settings are a moving target, reflecting recent developments in Leishmania diagnostics and therapeutics. Accumulating experience with molecular-based species identification has enabled species-directed therapy. Clinicians are reevaluating more toxic traditional regimens in light of newly approved therapeutic agents and emerging data on local cutaneous treatments. Referral centers are implementing treatment decision algorithms designed to maximize efficacy while minimizing adverse events. Although management strategies continue to evolve, treatment of CL in non-endemic settings remains controversial. Persistent reliance on expert opinion reflects lack of research focused on travellers and limited randomized controlled trial evidence. We herein review the current epidemiology of cutaneous leishmaniasis in travellers and species-specific evidence for available therapies.

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Clinical Guidelines For The Management Of Cutaneous Leishmaniasis In British Military Personnel

Cited by 33 publications

References 14 publications

Tropical skin diseases in British military personnel

Tropical skin diseases in British military personnel

An ulcer that will not heal

Cutaneous Leishmaniasis in Travellers: a Focus on Epidemiology and Treatment in 2015

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