Successful treatment of cutaneous leishmaniasis with intralesional meglumine antimoniate: A case series

Arboleda, Margarita; Barrantes, Santiago; Usuga, Luz Yaned; Robledo, Sara M.

doi:10.1590/0037-8682-0211-2018

Cited by 15 publications

(8 citation statements)

References 6 publications

(8 reference statements)

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“…In contrast, AO is an inexpensive drug; it can be produced by its extraction from annatto seeds. NLCcp2 and NLCcp4 (5.0 µg/mL) demonstrated superior performance compared to Glucantime ® (200 and 400 µg/mL) (p < 0.05), the first choice antileishmanial drug for the treatment of cutaneous leishmaniasis by the intramuscular (IM) and intravenous (IV) routes, or most recently intralesional administration [72]. However, severe side effects have been reported like nephrotoxicity, hepatotoxicity, acute pancreatitis, cardiac alterations, and reports of varicella-zoster reactivation attributed to glutathione use [73].…”

Section: Antileishmanial Activity (In Vitro)mentioning

confidence: 99%

Annatto Oil Loaded Nanostructured Lipid Carriers: A Potential New Treatment for Cutaneous Leishmaniasis

et al. 2021

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Annatto (Bixa orellana L.) is extensively used as food pigment worldwide. Recently, several studies have found it to have healing and antioxidant properties, as well as effective action against leishmaniasis. Therefore, the purpose of this study was to incorporate the oil obtained from annatto seeds into a nanostructured lipid carrier (NLC) and evaluate its physicochemical properties and biological activity against Leishmania major. Nanoparticles were prepared by the fusion-emulsification and ultrasonication method, with the components Synperonic™ PE (PL) as the surfactant, cetyl palmitate (CP) or myristyl myristate (MM) as solid lipids, annatto oil (AO) (2% and 4%, w/w) as liquid lipid and active ingredient, and ultra-pure water. Physicochemical and biological characterizations were carried out to describe the NLCs, including particle size, polydispersity index (PDI), and zeta potential (ZP) by dynamic light scattering (DLS), encapsulation efficiency (EE%), thermal behavior, X-ray diffraction (XRD), transmission electron microscopy (TEM), Electron Paramagnetic Resonance (EPR), cytotoxicity on BALB/c 3T3 fibroblasts and immortalized human keratinocyte cells, and anti-leishmaniasis activity in vitro. Nanoparticles presented an average diameter of ~200 nm (confirmed by TEM results), a PDI of less than 0.30, ZP between −12.6 and −31.2 mV, and more than 50% of AO encapsulated in NLCs. Thermal analyses demonstrated that the systems were stable at high temperatures with a decrease in crystalline structure due to the presence of AOs (confirmed by XRD). In vitro, the anti-leishmania test displayed good activity in encapsulating AO against L. major. The results indicate that the oily fraction of Bixa orellana L. in NLC systems should be evaluated as a potential therapeutic agent against leishmaniasis.

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Section: Antileishmanial Activity (In Vitro)mentioning

confidence: 99%

Annatto Oil Loaded Nanostructured Lipid Carriers: A Potential New Treatment for Cutaneous Leishmaniasis

et al. 2021

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“…Additionally, we recognize the possibility of selection bias, as all cases were collected from the in‐hospital setting and probably include patients with a more severe perception of their symptoms. Finally, we have not looked at the possibility of recurrence; however, this has been described previously, 19‐21 and further studies with long‐term surveillance are needed to allow real appreciation of relapse rate in both facial and non‐facial CL. Our study’s main points of strength include the relatively large number of cases with documented follow‐up treatment and the fact that all CL diagnoses were made by PCR.…”

Section: Discussionmentioning

confidence: 97%

Comparison between cutaneous leishmaniasis patients with facial and non‐facial lesions

et al. 2021

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Background We compared demographic, clinical, treatment, and outcome characteristics of facial cutaneous leishmaniasis (CL) and non‐facial CL. Methods In this retrospective cohort study, polymerase chain reaction confirmed Leishmania major CL patients with ≥2 documented hospital visits, 2014–2019, were included. Results Overall, 134 patients (34% and 66% with facial and non‐facial CL, respectively) were included. Facial CL patients were younger (43% vs. 8% <18 years, P < 0.001), with a higher proportion of females (41% vs. 25%, P = 0.07) compared with non‐facial CL. Clinical characteristics, including number and size of lesions and ulcer appearance, were similar in both the groups. Higher paromomycin/methylbenzethonium chloride ointment treatment rates were noted in facial CL (85% vs. 64%, P = 0.02). Intralesional sodium stibogluconate was given to 41% and 53% of facial CL and non‐facial CL patients, respectively (P = 0.21). Cryotherapy and surgery were only used in non‐facial CL patients (5% and 1% of all CL cases, respectively). Systemic treatment (oral miltefosine, intravenous [IV] sodium stibogluconate, IV liposomal amphotericin B) was used in <5% of the cases in both the groups. Overall, 84% of patients showed signs of improvement, including decreased lesion size or clinical improvement in 73% and 75% of patients, respectively. Only 5% of all cases healed without scarring. Outcome rates were similar in both groups. Conclusions Facial CL patients were younger and received more frequently Leishmania‐specific topical treatment than non‐facial CL patients. In contrast, the two groups were similar regarding clinical characteristics and outcome. These findings suggest differences in disease severity perception by patients and physicians.

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“…Regarding topical therapy, the possibility of using the antimony meglumine itself, as well as cryotherapy and the use of CO2 laser, has been suggested. [8,9].…”

Section: Discussionmentioning

confidence: 99%

American Cutaneous Leishmaniasis: A Pleomorphic Disease with Unusual Clinical Presentations - Report of Three Cases

Chichester¹,

Reis²,

Castanheira³

et al. 2020

int arch med

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Background: Cutaneous leishmaniasis (CL) is an infectious disease caused by a protozoan of the genus Leishmania and is transmitted by the anopheline mosquito. This study focused on describe three cases of atypical clinical presentations on patients with American cutaneous leishmaniasis from Dermatology Department of the State University of the State of Pará. Methods and Findings: Three patients assisted at a referral service between 2017 and 2019 are reported, based on clinical interview, histopathological analysis and polymerase chain reaction. On the first patient, it was observed keratotic erythematous vegetative plaque measuring 10x8 cm, with satellite lesions, in the left lower limb; the second patient presented an erythematous infiltrated plaque with crusts, on left ear for 6 months, with progressive growth; the third patient showed erythematous infiltrated plaques, sometimes ulcerated, in the trunk and face, with a zosteriform aspect. All three patients had the diagnosis confirmed by polymerase chain reaction and histopathological analysis. Conclusions: The wide range of clinical manifestations may be related to factors such as: use of immunosuppressive drugs, concomitant infections with more than one variety of Leishmania spp. and association with other systemic diseases, with HIV co-infection and diabetes being the main associated diseases. Thus, it is always necessary to evaluate such comorbidities on patients with leishmaniasis suspection, in order to avoid misdiagnosis.

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Successful treatment of cutaneous leishmaniasis with intralesional meglumine antimoniate: A case series

Cited by 15 publications

References 6 publications

Annatto Oil Loaded Nanostructured Lipid Carriers: A Potential New Treatment for Cutaneous Leishmaniasis

Annatto Oil Loaded Nanostructured Lipid Carriers: A Potential New Treatment for Cutaneous Leishmaniasis

Comparison between cutaneous leishmaniasis patients with facial and non‐facial lesions

American Cutaneous Leishmaniasis: A Pleomorphic Disease with Unusual Clinical Presentations - Report of Three Cases

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