The efficacy of treatment with intralesional meglumine antimoniate alone, compared with that of cryotherapy combined with the meglumine antimoniate or intralesional sodium stibogluconate, in the treatment of cutaneous leishmaniasis

Abstract

It would be very useful to have a more effective and more rapid method available for the treatment of cutaneous leishmaniasis (CL). The main aim of the present, Iranian study, was to see if the combination of cryotherapy and intralesional injections with meglumine antimoniate (C + MA) would be more effective than the injections given alone (MA) or the combination of cryotherapy plus intralesional sodium stibogluconate (C + SS). Forty patients (with 67 lesions) were treated with C + MA, another 40 (with 65 lesions) were treated with C + SS and 100 patients (with 180 lesions) were treated with MA. Follow-up for 6 months after the final treatment indicated that 89.5% of the lesions treated with C + MA, 92.3% of those treated with C + SS but only 50% of the lesions treated with MA only were completely cured. The frequencies of cure in the two cryotherapy groups were similar, both being significantly higher than that in the MA group (P < 0.05). The combination of cryotherapy with intralesional injections of meglumine antimoniate or sodium stibogluconate, which is much more effective than the use of intralesional meglumine antimoniate alone, should be promoted.

Intralesional Pentamidine: A Novel Therapy for Single Lesions of Bolivian Cutaneous Leishmaniasis

“…1 In an attempt to improve upon this cure rate by increasing the number of ILSb injections, the present report first compared ILSb-3 injections versus ILSb-5 injections. In the Old World, another approach to improving the cure rate of ILSb is to combine ILSb with cryotherapy, [10][11][12][13] but with L. braziliensis in our hands, cryotherapy was both ineffective and poorly tolerated. 1 In Study 1 of the present report, the cure rate for ILSb-3 injections was 57% versus a cure rate for ILSb-5 injections of 73%.…”

Treatment of acute Old World cutaneous leishmaniasis: A systematic review of the randomized controlled trials

“…[37][38][39] Different methods were used, but one of the most commonly described methods was a two-cycle freeze and thaw using liquid nitrogen at weekly or fortnightly intervals. Usually, liquid nitrogen was applied to each lesion using a cotton-wool swab for 10 to 25 seconds and a 1-to 2-mm wide ring of the surrounding normal tissue appeared frozen.…”

Leishmaniasis: Epidemiology, Control and Future Perspectives with Special Emphasis on Egypt

“…For instance, around 90% healing rate from L. tropica infection in turkey was reported after one session of cryotherapy in combination with liquid nitrogen [72]. Another example for using of cryotherapy was reported in two studies in Iran, but this time in combination with local antimonials [73,74]. In the first study, high recovery rates from cutaneous leishmaniasis were reported with cryotherapy combined with intra-lesion antimonial, than antimonial by itself.…”