An overview of skin lesions adapted to Cutaneous Leishmaniasis in Persian Medicine

Efficacy of a Combined Herbal Product Containing Indigofera argentea, Pistacia atlantica and Salvia hispanica in Zoonotic Cutaneous Leishmaniasis Patients Treated along Glucantime ®

Background

Leishmaniasis is highly prevalent worldwide, and while conventional medicine offers numerous treatment methods for cutaneous leishmaniasis, Iranian traditional medicine suggests various remedies. We aimed to evaluate the efficacy of an herbal combination containing Indigofera argentea leaves, Pistacia atlantica resin, and Salvia hispanica seeds in patients with zoonotic cutaneous leishmaniasis.

Methods

This study was conducted at the Leishmaniasis Department of Chabahar Health Center in southeastern Iran in 2021. It was a double-blinded randomized clinical trial involving 68 patients enrolled after clinical diagnosis, examination of smear samples using Giemsa staining, and PCR confirmation. The volunteers were randomly divided into intervention and control groups. Both groups received 'Glucantime ® as the primary medication weekly until complete healing or up to 12 weeks. Glucantime ® was administered intralesionally at a dosage of 0.1 cc on the wound's margin, with repeat injections at 1 cm intervals along the wound edge when necessary. In addition to the main drug, the intervention group received the herbal product topically twice daily until wound healing or for up to 4 weeks, while the control group received a placebo in the same manner.

Results

82.35% of patients in the intervention group and 20.58% in the control group achieved complete healing within four weeks. There was a significant difference between the two groups (P < 0.001).

Conclusion

The herbal product demonstrated effectiveness in treating patients with zoonotic cutaneous leishmaniasis.

Epidemiology, Associated Factors and Treatment Methods of Cutaneous Leishmaniasis Based on Previous Data from 2013 to 2018 in Ilam, Western Iran

OBJECTIVE

The aim of this study was to evaluate the epidemiology, clinical presentation and types of treatment of cutaneous leishmaniasis (CL) in the province of Ilam (Western Iran) in 5 years (from May 2013 to January 2018). This cross-sectional study involved patients diagnosed with CL who were referred to Mehran City Health center.

METHODS

All patients were diagnosed by clinical and parasitological (Giemsa staining of lesion to observe the parasite) methods. Moreover, a structured questionnaire on demographic data including age, sex, occupation, number and site of the lesions, treatment regimen was administered to each case.

RESULTS

In total, 2001 positive CL cases were observed in this study. The highest prevalence of CL was reported in the autumn season and mainly among male subjects residing in urban communities. The prevalence of CL varied with the age group: higher in the age group of 1-10 years than other groups. Besides, hands and faces were the most affected regions of the body. Most of the cases (47.35%) were managed by topical treatment (glucantime) and cryotherapy followed by systemic treatment (pentavalent antimony) 26.85%.

CONCLUSIONS

The prevalence of disease varied with age, increasing the prevalence rate in children due to their habitats, the highest prevalence in autumn due to climatic conditions. These findings help to better discuss the prevention and treatment of infections.

Overview of herbal and traditional remedies in the treatment of cutaneous leishmaniasis based on Traditional Persian Medicine

This study aims to describe the herbal and traditional remedies in the treatment of cutaneous leishmaniasis (CL) with an overview on related available evidence in modern medicine. This study is a review that focuses on the most important Traditional Persian Medicine (TPM) sources including Avicenna's Canon of Medicine, Jorjani's Zakhīra-yi Khārazmshāhī, and Aazam-Khan's Eksir-e-Aazam, as well as pertinent information from Embase, PubMed, Scopus, Scientific Information Database, and Google Scholar by using the keywords salak, rīsh-e-balkhi, cutaneous leishmaniasis, and leishmaniasis for selected remedies. Several oral and topical herbal remedies, such as Vitis vinifera L. (Unripe grapes), Berberis vulgaris L., Rheum ribes L., Santalum album L., Cinnamomum camphora (L.) J.Presl (Camphor), Brassica nigra (L.) K. Koch, Crocus sativus L., Juniperus excelsa M. Bieb, honey, and Alum root, were mentioned in TPM resources for the treatment of CL. Furthermore, cauterization, cupping, and leech therapy were considered for this purpose. In this review, some evidence-based studies will also be presented that have demonstrated the therapeutic properties of some of these products. In conclusion, the sages of TPM have recommended several systemic or topical medications, in addition to physical procedures, for treatment of CL, all of which could be a base for conducting further research on its efficacy.

Route map for the discovery and pre-clinical development of new drugs and treatments for cutaneous leishmaniasis

Although there have been significant advances in the treatment of visceral leishmaniasis (VL) and several novel compounds are currently in pre-clinical and clinical development for this manifestation of leishmaniasis, there have been limited advances in drug research and development (R & D) for cutaneous leishmaniasis (CL). Here we review the need for new treatments for CL, describe in vitro and in vivo assays, models and approaches taken over the past decade to establish a pathway for the discovery, and pre-clinical development of new drugs for CL. These recent advances include novel mouse models of infection using bioluminescent Leishmania, the introduction of PK/PD approaches to skin infection, and defined pre-clinical candidate profiles.

Nodular Lymphangitis (Sporotrichoid Lymphocutaneous Infections). Clues to Differential Diagnosis

Nodular lymphangitis, also known as sporotrichoid lymphocutaneous infections, is characterized by suppurative inflammatory nodules along the lymphatic vessels. This manifestation is classic of sporotrichosis, however, other infections such as nocardiosis, atypical mycobacteriosis, leishmaniasis, among others, can also express this clinical pattern. Sporotrichosis, which often occurs in gardeners, remains the most recognized cause of nodular lymphangitis. The histopathological studies, as well as the culture are diagnostic standards of lesions that do not respond to empirical treatment. In this article, we will review the main causes of nodular lymphangitis or lymphocutaneous sporotrichoid infections.