Recurrent cutaneous leishmaniasis

Gomes, Ciro Martins; Damasco, Fabiana dos Santos; Morais, Orlando Oliveira de; Paula, Carmen Déa Ribeiro de; Sampaio, Raimunda Nonata Ribeiro

doi:10.1590/abd1806-4841.20131885

Cited by 9 publications

(8 citation statements)

References 8 publications

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“…The anti-TNF- α action of pentoxifylline makes its use interesting, mainly in cases of mucosal and/or treatment-refractory leishmaniasis, since this cytokine is the main responsible for mucosal damage. There have been reports of success in the combination of pentoxifylline and meglumine antimoniate in the treatment of treatment-refractory cases [14] and with high production of TNF- α [89] or recurrent cases [90].…”

Section: Discussionmentioning

confidence: 99%

Pentavalent Antimonials Combined with Other Therapeutic Alternatives for the Treatment of Cutaneous and Mucocutaneous Leishmaniasis: A Systematic Review

Berbert

Mello

Nassif

et al. 2018

Dermatology Research and Practice

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The first choice drugs for the treatment of cutaneous and mucocutaneous leishmaniasis are pentavalent antimonials, sodium stibogluconate, or meglumine antimoniate. However, the treatment with these drugs is expensive, can cause serious adverse effects, and is not always effective. The combination of two drugs by different routes or the combination of an alternative therapy with systemic therapy can increase the efficacy and decrease the collateral effects caused by the reference drugs. In this systematic review we investigated publications that described a combination of nonconventional treatment for cutaneous and mucocutaneous with pentavalent antimonials. A literature review was performed in the databases Web of Knowledge and PubMed in the period from 01st of December 2004 to 01st of June 2017, according to Prisma statement. Only clinical trials involving the treatment for cutaneous or mucocutaneous leishmaniasis, in English, and with available abstract were added. Other types of publications, such as reviews, case reports, comments to the editor, letters, interviews, guidelines, and errata, were excluded. Sixteen articles were selected and the pentavalent antimonials were administered in combination with pentoxifylline, granulocyte macrophage colony-stimulating factor, imiquimod, intralesional sodium stibogluconate, ketoconazole, silver-containing polyester dressing, lyophilized LEISH-F1 protein, cryotherapy, topical honey, and omeprazole. In general, the combined therapy resulted in high rates of clinical cure and when relapse or recurrence was reported, it was higher in the groups treated with pentavalent antimonials alone. The majority of the articles included in this review showed that cure rate ranged from 70 to 100% in patients treated with the combinations. Serious adverse effects were not observed in patients treated with drugs combination. The combination of other drugs or treatment modalities with pentavalent antimonials has proved to be effective for cutaneous and mucocutaneous leishmaniasis and for most seemed to be safe. However, new randomized, controlled, and multicentric clinical trials with more robust samples should be performed, especially the combination with immunomodulators.

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Section: Discussionmentioning

confidence: 99%

Pentavalent Antimonials Combined with Other Therapeutic Alternatives for the Treatment of Cutaneous and Mucocutaneous Leishmaniasis: A Systematic Review

Berbert

Mello

Nassif

et al. 2018

Dermatology Research and Practice

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“…However, it should be noted that LRC most commonly occurs within 2 years of cure, and recurrence after this period is an extremely rare event. 2,21 Among patients diagnosed with ACL during our study spanning 17 years, the percentage of patients who developed LRC was 1.34%. In most prospective studies, the mean follow-up time after treatment is 12 months, thereby making it difficult to measure long-term recurrence.…”

Section: Discussionmentioning

confidence: 88%

“…Unfortunately, we were unable to find any clinical or laboratory evidence in this patient that could explain this long period of latency. However, it should be noted that LRC most commonly occurs within 2 years of cure, and recurrence after this period is an extremely rare event …”

Section: Discussionmentioning

confidence: 99%

The influence of treatment on the development of leishmaniasis recidiva cutis: a 17‐year case–control study in Midwestern Brazil

Gomes

Cesetti

Morais

et al. 2014

Acad Dermatol Venereol

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The incidence of LRC among ACL patients was 1.34%. The analysis included 105 patients; 82 patients (78%) were in the control group, and 23 patients (22%) were in the LRC case group. The data analysis indicated that the standard treatment N-methylglucamine antimoniate (N-MA) reduced the development of LRC in bivariate (odds ratio (OR) = 0.34; 95% CI = 0.13-0.91) and multivariate analyses (OR = 0.16; 95% CI = 0.03-0.86; P = 0.03). However, no differences in LRC incidence were observed when the standard treatment N-MA and alternative drugs, such as pentamidine and amphotericin B, were considered (OR = 0.47; 95% CI = 0.16-1.35) CONCLUSION: We conclude that the standard treatment N-MA, as proposed by the Brazilian Ministry of Health, is effective in the prevention of LRC. Although other drugs have shown promising results in LRC, more scientific evidence is needed to assess their efficacy compared with N-MA.

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“…A defect in the T-lymphocyte activation by the protozoa would cause the inability of the macrophages to kill all amastigotes [24,9]. Relapses may occur after months or up to 30-40 years after the first manifestations of the disease, but more commonly within 2 years [8,11,26].…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of LR is notoriously difficult. According to the literature, it includes systemic therapy with pentavalent antimony, alone or in combination with allopurinol or pentoxifylline [26], amphotericin B, and local therapy with intralesional antimonials, cryosurgery, or excision. In children, fluconazole may represent an effective and welltolerated therapy [29,30], although we think that for L. aethiopica, pentamidine, which is hardly available in the country, is the treatment of choice [31].…”

Section: Discussionmentioning

confidence: 99%

Leishmaniasis recidivans in Ethiopia: cutaneous and mucocutaneous features

Dassoni

Daba

Naafs³

et al. 2017

J Infect Dev Ctries

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Cutaneous leishmaniasis (CL) is endemic in Ethiopia. An unusual clinical form of this disease is leishmaniasis recidivans (LR), a prolonged, relapsing form of cutaneous leishmaniasis resembling tuberculosis of the skin that may persist for many years with a chronic and relapsing course. This rare variant has been shown to be caused by Leishmania tropica species in the Old World and by Leishmania braziliensis, Leishmania amazonensis, Leishmania panamensis, and Leishmania guyanensis in the New World, as reported in various studies. To our knowledge, there are no reports from Ethiopia, and mucocutaneous involvement of LR has not been described to date. This was a retrospective analysis of the patients seen at the Italian Dermatological Center in Mekelle on the Tigrean highlands over a threeyear period (2008)(2009)(2010)(2011). Seven patients with typical clinical features of LR were seen. Two of them presented with signs of mucosal involvement. To date, Leishmania aethiopica is shown to be the only species causing CL that is endemic in the Ethiopian highlands. Therefore, it had to be assumed that the lesions in these patients were caused by this species. The aims of this communication are to report, for the first time, the presence of LR, most likely due to Leishmania aethiopica, in Ethiopia, and to report mucosal involvement in this rare clinical form of CL.

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Recurrent cutaneous leishmaniasis

Cited by 9 publications

References 8 publications

Pentavalent Antimonials Combined with Other Therapeutic Alternatives for the Treatment of Cutaneous and Mucocutaneous Leishmaniasis: A Systematic Review

Pentavalent Antimonials Combined with Other Therapeutic Alternatives for the Treatment of Cutaneous and Mucocutaneous Leishmaniasis: A Systematic Review

The influence of treatment on the development of leishmaniasis recidiva cutis: a 17‐year case–control study in Midwestern Brazil

Leishmaniasis recidivans in Ethiopia: cutaneous and mucocutaneous features

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