BACKGROUND Topical treatment of New World cutaneous leishmaniasis can be affected by bacterial coinfection, hyperkeratosis, and transdermal drug delivery. OBJECTIVE The aim of this work was to evaluate the therapeutic response and safety of the topical, sequential use of antiseptic, keratolytic, and pentamidine isethionate (PMD) creams (3-PACK kit) on CL-infected BALB/c mice. METHODS A 0.5% chlorhexidine solution (CGH), 10% salicylic acid (SA), and 3% or 6% PMD were used as antiseptic, keratolytic, and antileishmanial drugs, respectively. During the first seven days, antiseptic, followed by 10% SA gel and PMD cream, were applied topically. Subsequently, treatment was performed only with the antiseptic and PMD creams. Skin irritation, reduction of lesion size (mm 2 ), and parasitic load were observed until 30 days of treatment were completed. FINDINGS The 3-PACK treatment using 6% PMD induced a complete lesion reduction in 3/6 mice and a partial reduction in 1/6 mice, with no parasites observed. In contrast, CGH and SA alone, along with the vehicle, were not effective (p < 0.05). Moderate to severe erythema was observed at the application site. MAIN CONCLUSION The topical 3-PACK using 6% PMD was 67% effective in the treatment of CL by Leishmania (Viannia) braziliensis . Currently, work is ongoing to improve PMD isethionate formulation and to determine a dose-response.

Cutaneous leishmaniasis is a skin disease caused by flagellate protozoa of the genus Leishmania and transmitted by sandflies of the genus Lutzomyia. Around 1 million new cases occur in the world annually, with a total of 12 million people affected, mainly in rural areas with low access to health services and adequate treatments. In the area of the Americas, Colombia has one of the highest infection rates after Brazil. Topical treatments with pentamidine isethionate (PMD) present an attractive alternative due to their ease of application and low costs. However, cutaneous leishmaniasis lesions present nodules with seropurulent exudate that, when drying, form hyperkeratotic lesions, hindering the effective penetration of drugs for their treatment. The use of molecular histology techniques, such as MALDI-MSI, allow in situ evaluation of the penetration of the treatment to the sections of the dermis where the disease-causing parasite resides. However, the large volume of information generated makes it impossible to process it manually. Machine learning techniques allow the unsupervised processing of large amounts of information, generating prediction models for the classification of new information. This work proposes a low-cost method to generate cutaneous leishmaniasis detection and classification models using MALDI-MSI images taken from murine models. The proposed models allow a 95% efficiency when separating healthy samples from infected samples and an effectiveness of 67% when separating effectively treated samples from unsuccessfully treated samples.

La Medicina Preventiva comprende como principios: las atenciones de salud y las de Atención Médica. La formación del médico se realizaba atendiendo a los enfermos en los hospitales; el desarrollo de la Atención Primaria de salud ha posibilitado la formación en las comunidades con el objetivo esencial de la atención a la salud de la población. La metodología utilizada para el presente trabajo de investigación. La técnica para la recolección de datos está constituida por materiales electrónicos, estos últimos como Google Académico, entre otros, apoyándose para ello en el uso de descriptores certificados y avalados por el tesauro de la UNESCO. La información aquí obtenida será revisada, resumida y analizada para su exposición organizada en los resultados. Los aspectos fundamentales de la medicina general es que tiene la capacidad dentro de su acción vertical de delegar incidencias a otras especialidades y centros de salud que lo ambulatorio no tiene la capacidad de atender, por ello la importancia de los médicos generales e internistas en estos procesos de captación y filtro a la hora de la atención primaria a la población. Sin embargo, el sistema a manera integral no puede funcionar si en primera instancia no existen la cantidad de centros de salud necesarios por cantidad de habitantes al igual que médicos y enfermeras, sin dejar de restarle importancia a los insumos médicos.