The treatment of late cutaneous leishmaniasis by simultaneous intralesional steroid and intramuscular antimony

Treatment of recurrent cutaneous Leishmaniasis

BACKGROUND

Cutaneous leishmaniasis is endemic in Iran. One of the clinical pictures of this disease is leishmaniasis recidivans (LR). Most of the drugs used for cutaneous leishmaniasis are ineffective in LR.

METHODS AND PATIENTS

Twenty-five patients (13 women and 12 men), who had LR and whose disease had been proved by previous direct smears, were accepted for the study. The duration of disease in all patients was more than 2 years and they had previously been treated for their cutaneous leishmaniasis by different methods. All patients were treated with a combination of allopurinol (AL) (20 mg/kg/day for 30 days) and meglumine antimoniate (MA) (70 mg/kg/day for 15 days). Laboratory tests including hemograms, liver function, and kidney function tests, were done both at baseline and at the end of therapy.

RESULTS

Twenty-four out of 25 patients (96%) responded well to treatment and after 1 year follow-up no relapse had occurred. The drugs were well tolerated by the patients producing no side effects nor any significant changes in laboratory values.

CONCLUSIONS

A combination of AL and antimoniate is an effective method for the treatment of LR and for patients with cutaneous leishmaniasis who are resistant to the usual treatments.

Recurrent cutaneous leishmaniasis

A patient is presented who has a 71-year history of recurrent cutaneous leishmaniasis, despite treatment with antimonials, antituberculous drugs, and surgery. Classification and treatment of cutaneous leishmaniasis are discussed.