Hamideh Moravvej; Maryam Yousefi; Behrooz Barikbin
Volume 9, suppl.1 , 2006, , Pages 6-6
Abstract
Lupoid leishmaniasis is an unusual complication of acute cutaneous leishmaniasis which can represent a diagnostic and therapeutic challenge. The disease is actually a reactivation of an earlier acute cutaneous infection. It usually starts close to or in the scar of previous lesion and can cause severe ...
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Lupoid leishmaniasis is an unusual complication of acute cutaneous leishmaniasis which can represent a diagnostic and therapeutic challenge. The disease is actually a reactivation of an earlier acute cutaneous infection. It usually starts close to or in the scar of previous lesion and can cause severe destruction. Its diagnosis is complicated by the sparsity of the microorganisms in the direct smear and the tissue. The present report deals with a middle age Iranian woman presented to us with multiple scars on the whole face and also multiple red-down papules and nodules around these scars. After three years of clinical, histopathological and laboratory investigations and treating with no or minimal success for the diagnosed of discoid lupus erythematosus, sarcoidosis and lupus vulgaris, finally was diagnosed and treated successfully as lupoid leishmaniasis with meglumine antimoniate (Glucantime).
MA Nilfroush Zadeh; N Anasri; R Derakhshan
Volume 8, Issue 6 , 2006, , Pages 457-461
Abstract
Background and aim: Pentavalent antimony compounds are the first line treatment for cutaneous leishmaniasis. Clinical resistance to pentavalent antimony in the form of meglumine antimoniate (Glucantime) has been recognized as a problem in leishmaniasis. Herein, clinical response to Glucantime were studied ...
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Background and aim: Pentavalent antimony compounds are the first line treatment for cutaneous leishmaniasis. Clinical resistance to pentavalent antimony in the form of meglumine antimoniate (Glucantime) has been recognized as a problem in leishmaniasis. Herein, clinical response to Glucantime were studied in patients suffered from cutaneous leishmaniasis.Materials and Methods: In a cross-sectional study 370 patients with cutaneous leishmaniasis were treated with systemic Glucantime, 50 mg/kg/day, for 2 to 3 weeks. They were visited weekly for 3 weeks and also followed up for 3 months after treatment was completed. The clinical and parasitological response to this treatment was evaluated, and classified into partial and complete response and failure to treatment. Results: Two hundred forty-seven men and 123 women were followed up. The mean age was 36.7±16 years. There were 64.1% partial response after 2 weeks and 73% partial response at the third week of treatment. 11.6% of lesions were not cured after 3 weeks of treatment and 8.1% were not still cured 12 weeks thereafter.Conclusion: Clinical resistance to Glucantime is an important problem. The mechanisms of resistance and using drug combinations are needed to be considered.
MA Nilforoush Zadeh; F Jafari; N Ansari; Z Nilforoushan; AR Firooz
Volume 8, Issue 5 , 2005, , Pages 340-346
G Sadeghian; MA Nilforoush Zadeh; M Motevali Emami
Volume 8, Issue 4 , 2005, , Pages 251-255
Abstract
Background and objective: Different local and systemic modalities are suggested in the treatment of cutaneous leishmaniasis, but the pentavalent antimony compounds are still considered as the first line of treatment. Regarding to increase in clinical drug resistance and adverse effects, efforts to find ...
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Background and objective: Different local and systemic modalities are suggested in the treatment of cutaneous leishmaniasis, but the pentavalent antimony compounds are still considered as the first line of treatment. Regarding to increase in clinical drug resistance and adverse effects, efforts to find a more effective and safer drug is continuing. The objective of this study was to compare the effect of intra-lesional hypertonic sodium chloride solution and intra-lesional meglumine antimoniate injections in the treatment of cutaneous leishmaniasis.Materials and Methods: This randomized controlled clinical trial with simple sampling method was performed on 72 patients with cutaneous leishmaniasis. The patients were randomly divided in two groups. One group was treated with intra-lesional hypertonic sodium chloride solution and the other one was treated with intra-lesional meglumine antimoniate injections at weekly intervals for 6 to 10 weeks. All patients were followed for 6 months after treatment.Results: After six weeks of treatment, complete improvement, partial improvement, and no response to treatment were 33.3%, 45% and 22% in meglumine antimoniate group and 26%, 23% and 51% in trial group, respectively. In both groups complete improvement was observed in lesions smaller than 2 cm². In lesions with partial improvement the treatment was continued up to 10 weeks and all patients were followed for six months. After six months ultimate cure rate was 52% in meglumine antimoniate group and 25% in hypertonic sodium chloride solution group.Conclusion: Injections of hypertonic sodium chloride solution has less efficacy in comparison with intra-lesional meglumine antimoniate in treatment of cutaneous leishmaniasis, but considering the good response in primary small lesions, it can be used as an alternative therapy in some special cases including small lesions and allergic reactions to meglumine antimoniate.
