Treatment of cutaneous leishmaniasis by topical 25% podophyllin solution (single, blinded, therapeutic, controlled study)

Sharquie, Khalifa E.; Noaimi, Adil A.; Al-Ghazzi, Ahmed G.

doi:10.1016/j.jdds.2014.10.001

Cited by 17 publications

(18 citation statements)

References 15 publications

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“…When topical 40% Loranthus europaeus ointment was compared with 25% podophyllin solution, it was more safe as well as no any local or systemic side effects were recorded, although podophyllin is safe as shown in the pervious and present work [22] but, still caution should be taken when it is used to treat a large numbers of lesions, especially in infants in order to avoid systemic absorption and it is contraindicated in pregnant women were it is classified as category X [18].…”

Section: Discussionmentioning

confidence: 57%

Topical 40% <i>Loranthus europaeus</i> Ointment as an Alternative Medicine in the Treatment of Acute Cutaneous Leishmaniasis versus Topical 25% Podophyllin Solution

Sharquie¹,

Noaimi²,

Saleh³

et al. 2017

JCDSA

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Background: Cutaneous leishmaniasis (CL) is an endemic disease in Iraq, now is running in an outbreaks. Many therapies have been tried in treatment of the disease. Objective: Loranthus europaeus (LE) is a well-known medical plant and has many pharmacological effects in many in vitro studies. The aim of the study is to evaluate the effectiveness of 40% LE ointment and compared it with topical 25% podophyllin solution in treatment of acute CL. Patients and Methods: Thirty five patients with acute CL were enrolled in this single blinded, therapeutic, comparative study, which was done in the Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq during January 2015-Jully 2015. The total number of lesions were 86 (76 lesions treated and ten lesions in a covered area left without treatment as control). Duration of lesions ranged from 4 to 12 (7.37 ± 2.77) weeks. The size of lesions ranged from 0.5 -7 (2.81 ± 1.76) cm. Diagnosis was confirmed by biopsy and/or smears. Lesions were divided in to two groups and scored as (mild, moderate, marked, complete cure) according to a modified Sharquie's leishmania score to assess the objective response to the topical or systemic therapy. Group A: Thirty three (43.42%) lesions treated with topical 25% podophyllin solution once weekly for maximum 6 weeks. Group B: Forty three (56.58%) lesions treated with 40% LE ointment once daily at bedtime for 6 hours under occlusion for maximum 6 weeks. The followed-up was carried out every 2 weeks for 8 weeks during treatment, then monthly for next three months after end of therapy. Results: the total number of lesions was 86 lesions, 46 (53.49%) were ulcerated and 40 (46.51%) were dry; 18 (51.43%) patients had single lesion while 17 (48.57%) patients had multiple lesions. At the end of therapy (6 weeks after starting treatment), the cure rate was 84.84% in Group A, and 79.07% in Group B. When the two groups compared with each other there was no statistical significance difference were P value = 0.648. While untreated ten lesions that lefts as control did not showed any signs of healing. Conclusion: Topical 40% Loranthus europaeus ointment is a new effective modality for treatment of acute CL and as effective as 25% podophyllin solution with no any noticeable local or systemic side effects.

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Section: Discussionmentioning

confidence: 57%

Topical 40% <i>Loranthus europaeus</i> Ointment as an Alternative Medicine in the Treatment of Acute Cutaneous Leishmaniasis versus Topical 25% Podophyllin Solution

Sharquie¹,

Noaimi²,

Saleh³

et al. 2017

JCDSA

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“…Topical treatment of experimental cutaneous leishmaniasis in golden hamster (Mesocricetus auratus) with formulations containing pentamidine ACTA AMAZONICA (El-On et al 1993), Miltex® (Schmidt-Ott et al 1999, 25% podophyllin solution used topically (Sharquie et al 2015) and tamoxifen (Eissa et al 2011), that also used the size measurement methodology, clinical, and printing blade to monitor the effect of treatment. Also discussed was the possibility of using known drugs to develop new treatments that are also showing promising results.…”

Section: Discussionmentioning

confidence: 99%

Topical treatment of experimental cutaneous leishmaniasis in golden hamster (Mesocricetus auratus) with formulations containing pentamidine

et al. 2017

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Current treatment of cutaneous leishmaniasis (CL) relies mainly on pentavalent antimonials salts and second-line drugs include pentamidine and amphotericin B, but these therapies have side effects and require parenteral administration. The aim of this work was to evaluate the topical formulations containing pentamidine isethionate (PI) in the experimental treatment of cutaneous leishmaniasis (CL). Golden hamsters (Mesocricetus auratus) were infected in the nose with Leishmania (Leishmania) amazonensis. Six treatment groups received different topical treatments of anhydrous or hydrating emulsions, for a maximum of 10 days, with an application of 50 mg day -1. After treatment tissue samples of lesions were evaluated by histology, transmission electron microscopy and biopsy cultivation. Compared with untreated group, topical treatment with hydrating emulsion with 10% PI and usnic acid (ACE5AU) showed significantly decrease in volume lesion (P= 0.028) on 20 th day after the end of the treatment with reduction of 27.37%. Topical treatment with anhydrous emulsion with 10% PI and usnic acid (ACPU) reduces parasite burden in Golden hamsters. This study demonstrated the potential of topical treatment to reduce the number of parasites that could be combined with others drugs and to have a faster and more effective treatment of cutaneous leishmaniasis.

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“…Most recently microwave thermotherapy was used with (85.33%) cure rate [10], topical photodynamic therapy with (93.5%) cure rate [22] and topical podophyllin with (85%) cure rate [16], topical TCA with 65% cure rate [23].…”

Section: Discussionmentioning

confidence: 99%

“…Other systemic drugs that were used in treatment of CL like oral zinc sulfate, [4] [5] amphotericin B [9], rifampicin [25], antifungal agents [26]- [31], levamisole [32], dapsone [33] [34]. So the aim of present work is to use topical zinc sulphate rather than intralesional, as a simple non invasive mode of therapy for the patients, and to be compared with well-established topical therapy like 25% topical podophyllin sol [16]. Using Sharquie modified leishmania score, in the present study, to assess response to treatment, topical 25% podophyllin solution gave (82%) cure rate, while the cure rate using topical 25% zinc sulphate solution was (73.4%) and there was no statistical difference between the two therapies.…”

Section: Discussionmentioning

confidence: 99%

“…For simple cutaneous lesions which are few in number and where there is no risk of disfigurement or joint mobility restriction, topical application or local treatment would be a valuable option and often justified and many have been used like; azoles compound like; topical ketoconazole [13], clorimazole cream and miconazole cream [14]. Other compounds like; topical paramomycine [15] and recently topical podophyllin with 85% cure rate [16]. Topical therapy is an attractive choice as it is less toxic than systemic ones, and non painful as compared to intralesional therapies.…”

Section: K E Sharquie Et Almentioning

confidence: 99%

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Topical Therapy of Acute Cutaneous Leishmaniasis Using Zinc Sulphate Solution 25% versus Podophyllin Solution 25%

Sharquie¹,

Noaimi²,

Sharara³

et al. 2017

JCDSA

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Background: Zinc sulphate as intralesional and oral therapy was used as a successful therapy in treatment of cutaneous leishmaniasis while 25% topical podophyllin is now commonly used in the treatment of cutaneous leishmaniasis. Objective: To treat acute cutaneous leishmaniasis using topical zinc sulphate solution 25% to be compared with topical podophyllin solution 25%.Patients and Methods: This is a single, blind, interventional, comparative study done in the Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq during the period from January 2015 to June 2015. Forty patients with a total 88 lesions of acute cutaneous leishmaniasis were enrolled in this study; 54 (61.36%) were dry lesions and 34 (38.6%) were ulcerative type. The duration of lesions ranged from 2 -11 (7.7 + 2.483) weeks. The size of the lesions ranged from 0.3 to 8 (2.13 ± 1.53) cm. There were 21 females and 19 males, female to male ratio (1.1:1) and their ages ranged from 1 to 60 (25.92 ± 16.59) years. Diagnosis was confirmed by tissue smear and histopathology. Lesions were divided into two groups with matching types and sizes, and scored according to Sharquie modified Leishmania score to assess the objective response to the topical or systemic therapy and then during follow up responses were graded into mild, moderate, marked response and complete clearance. Group A treated with topical 25% podophyllin solution once weekly for a maximum of 6 weeks, while group B was treated with topical 25% zinc sulphate solution twice daily for 6 weeks. Follow up was every 2 weeks during therapy, and once monthly for 3 months after therapy. Results: A total of 40 patients with clinical diagnosis of acute cutaneous leishmaniasis were included in this study, with a total of 88 lesions. Fifteen (37.50%) patients had Conclusion: Topical zinc sulphate 25% is an effective simple non-invasive non-costly safe topical therapy for cutaneous leishmaniasis and without any contraindications for its use and free of side effects and was as effective as topical podophyllin.

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Treatment of cutaneous leishmaniasis by topical 25% podophyllin solution (single, blinded, therapeutic, controlled study)

Cited by 17 publications

References 15 publications

Topical 40% <i>Loranthus europaeus</i> Ointment as an Alternative Medicine in the Treatment of Acute Cutaneous Leishmaniasis versus Topical 25% Podophyllin Solution

Topical 40% <i>Loranthus europaeus</i> Ointment as an Alternative Medicine in the Treatment of Acute Cutaneous Leishmaniasis versus Topical 25% Podophyllin Solution

Topical treatment of experimental cutaneous leishmaniasis in golden hamster (Mesocricetus auratus) with formulations containing pentamidine

Topical Therapy of Acute Cutaneous Leishmaniasis Using Zinc Sulphate Solution 25% versus Podophyllin Solution 25%

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Treatment of cutaneous leishmaniasis by topical 25% podophyllin solution (single, blinded, therapeutic, controlled study)

Cited by 17 publications

References 15 publications

Topical 40% &lt;i&gt;Loranthus europaeus&lt;/i&gt; Ointment as an Alternative Medicine in the Treatment of Acute Cutaneous Leishmaniasis versus Topical 25% Podophyllin Solution

Topical 40% &lt;i&gt;Loranthus europaeus&lt;/i&gt; Ointment as an Alternative Medicine in the Treatment of Acute Cutaneous Leishmaniasis versus Topical 25% Podophyllin Solution

Topical treatment of experimental cutaneous leishmaniasis in golden hamster (Mesocricetus auratus) with formulations containing pentamidine

Topical Therapy of Acute Cutaneous Leishmaniasis Using Zinc Sulphate Solution 25% versus Podophyllin Solution 25%

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Topical 40% <i>Loranthus europaeus</i> Ointment as an Alternative Medicine in the Treatment of Acute Cutaneous Leishmaniasis versus Topical 25% Podophyllin Solution

Topical 40% <i>Loranthus europaeus</i> Ointment as an Alternative Medicine in the Treatment of Acute Cutaneous Leishmaniasis versus Topical 25% Podophyllin Solution