Maryam Khalili; Saman Mohammadi; Mohamadhosein Saeidi; Rezvan Amiri; Amireh Heshmatkhah; Simin Shamsi Meymandi; Mahin Aflatoonian
Abstract
Background: Treatment failure of antimony drugs for anthroponoticcutaneous leishmaniasis (ACL) is rising. Recognizing predictivefactors of unresponsiveness to treatment can substantiallyinfluence better ACL management. The goal of this study wasto investigate predictive factors associated with treatment ...
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Background: Treatment failure of antimony drugs for anthroponoticcutaneous leishmaniasis (ACL) is rising. Recognizing predictivefactors of unresponsiveness to treatment can substantiallyinfluence better ACL management. The goal of this study wasto investigate predictive factors associated with treatment failurein ACL in Kerman, southeast Iran.Methods: This case-control study was conducted retrospectivelyon 2,128 ACL cases in Kerman over ten years from 2011 to 2020.The case group included patients whose lesions failed to resolveafter one treatment course. The control group included thosewhose lesions were cured after one treatment course.Results: Treatment failure was observed in 13.5% of cases (10.7%of systemic therapy and 16.7% of local therapy). No significantdifference was reported between the type of treatment andtreatment failure. The association of treatment failure withwinter-onset (P = 0.001, OR = 1.39, CI = 1.23–1.56), face (P = 0.001,OR = 1.86, CI = 1.38–2.49), ulceration (P = 0.01, OR = 0.51, CI = 0.30–0.85), small diameter (P = 0.005, OR = 0.57, CI = 0.38-0.84) andlong duration of lesions (P = 0.01, OR = 1.57, CI = 1.11–2.21) wasvalidated by multivariate logistic regression analysis.Conclusion: Efficient detection and timely management of ACLcases are essential to reduce resistant cases, as lesions lastinglonger than four months show poor response to treatment.Furthermore, early treatment of facial lesions with systemictherapy is suggested to optimize results and reduce the risk ofdisfiguring scars. Further surveys are required to determine thereason behind more treatment failure in winter-onset lesions.
Vahid Mashayekhi Goyonlo; Hossein Hassan Abadi; Hanieh Zandi; Jamshid Jamali; Yalda Nahidi; Ahmad Reza Taheri; Bita Kiafar
Abstract
Background: The treatment of cutaneous leishmaniasis has long been a challenge. The application of heat to the lesions has been described in some studies, with no consensus regarding the types of thermotherapy and their practical implications.We sought to evaluate the efficacy of infrared thermotherapy ...
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Background: The treatment of cutaneous leishmaniasis has long been a challenge. The application of heat to the lesions has been described in some studies, with no consensus regarding the types of thermotherapy and their practical implications.We sought to evaluate the efficacy of infrared thermotherapy in the treatment of cutaneous leishmaniasis. Methods: We evaluated the results of infrared thermotherapy in 35 cutaneous leishmaniasis patients (53 lesions) who attended the leishmaniasis clinic of Imam Reza Hospital, Mashhad, Iran. Three times a week, the lesions were warmed to 45 degrees centigrade for two cycles of 10 minutes. Treatment outcomes were classified as complete (90-100%), good (50-89%), and poor responses (less than 50% size reduction). Results: Thirteen (24.5%) lesions were cured after three months; 31 (58.5%) and 9 (17%) lesions showed good and poor responses, respectively. Treatment outcomes were significantly related to the number of treatment sessions (P ≤ 0.05). No significant side effects were seen. Conclusion: Infrared thermotherapy is a relatively effective and well-tolerated treatment for cutaneous leishmaniasis.
Yalda Nahidi; Vahid Mashayekhi Goyonlo; Pouran Layegh; Hoda Marhamati; Mona Najaf Najafi
Abstract
Background: Zinc is an effective factor in the immune response against infectious agents; its effect on the course of cutaneous leishmaniasis (CL) is unknown. This study aimed to compare the serum zinc level in patients with acute and chronic CL. Methods: A descriptive study was conducted on 120 CL cases ...
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Background: Zinc is an effective factor in the immune response against infectious agents; its effect on the course of cutaneous leishmaniasis (CL) is unknown. This study aimed to compare the serum zinc level in patients with acute and chronic CL. Methods: A descriptive study was conducted on 120 CL cases and controls. This included 30 cases of acute CL (less than one year of lesion recovery), 30 cases of chronic CL (period of illness over one year), and 60 healthy subjects with age and gender proportional to the patients. Volunteers entered the study with knowledge and consent. The serum zinc level was measured by atomic absorption spectrophotometry. Results: The percentages of people with reduced serum zinc levels in the healthy, acute, and chronic groups were 13.3, 50, and 43.3%, respectively, whereby there was a significant difference between the leishmaniasis groups (acute and chronic) and the control group (p <0.001). However, the mean serum zinc level did not differ significantly between the acute (75.36 ± 15.72 µg/dl) and chronic (73.96 ± 17.98 µg/dl) leishmaniasis groups (P=0.94). Conclusions: A reduced serum zinc level is associated with symptomatic CL, but does not affect the clinical outcome and recovery.
Nasrin Hamidizadeh; Behrooz Barikbin; Maryam Yousefi; Abbas Sahraei; Ali Khamesipour; Shima Younespour; Hanif Sadeghitehrani
Volume 14, Issue 2 , 2011, , Pages 48-51
Abstract
Introduction: Cutaneous Leishmaniasis (CL) is a parasitic disease caused by Leishmania species. Currently accessible treatments remain insufficient, and there is pressure to develop suitable and effectual options. In this study, we used different concentrations of podophyllin in vitro on leishmania parasites ...
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Introduction: Cutaneous Leishmaniasis (CL) is a parasitic disease caused by Leishmania species. Currently accessible treatments remain insufficient, and there is pressure to develop suitable and effectual options. In this study, we used different concentrations of podophyllin in vitro on leishmania parasites and then on leishmaniasis lesions in mice and compared their efficacy. Method: We used podophyllin (14.3 µg/ml) in vitro against leishmania major parasites, then in experimental animals in different concentrations. Results: Podophyllin (14.3 µg/ml) that used in vitro eradicated leishmania major parasites, but, in mice after four weeks was not effective and the diameter of the lesions increase with use of topical podophyllin. Conclusion: Despite the lethal effect on leishmania in vitro, treatment with different doses of podophyllin could not accelerate the healing process of the leishmaniasis lesions of the experimental rats.
Mashayekhi Vahid; Maleki Masoud; Javidi Zari; Mahmodi Mahmoud; Taheri Ahmad Reza; Mehrabi Reza
Volume 11, Issue 2 , 2008, , Pages 60-63
Abstract
Background: It appears that chronic lupoid leishmaniasis is the result of type 2 predominant T helper response to parasite and a defect in the down regulation of IL-4 production during infection. The objective of this study was to evaluate the underlying immune status in these patients and their predominant ...
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Background: It appears that chronic lupoid leishmaniasis is the result of type 2 predominant T helper response to parasite and a defect in the down regulation of IL-4 production during infection. The objective of this study was to evaluate the underlying immune status in these patients and their predominant T helper activity we considered serum IgE as an indicator of TH2 activity and IL-4 production as it has been shown in atopic diathesis.Methods: In 34 cases of chronic lupoid leishmaniasis serum IgE level was measured and compared with 34 control cases of age and sex matched healthy individuals without atopic diathesis. P< 0.05 was considered statistically significant.Results: There were 21 females and 13 males with a mean age of 14.35±8.3 years in the patients group. The mean age of the control group was 16.11±8.4 (P>0.05 and matched). Nine patients had atopic diathesis. Mean serum IgE level in patients and in the control group was 102.6±22.4 i.u/ml and 135.6±24.9 i.u/ml, respectively (P>0.05 with no significant difference). Mean serum IgE level in patients without atopic diathesis (25 cases) was 66.8±11.3i.u/ml which was significantly lower than the control group (P<0.05).Conclusion: In this study, serum IgE level in cases with chronic lupoid leishmaniasis was lower than the control group and it seems that in these patients, there is not an underlying Th2 over activity as it is seen in atopic diathesis.
Hejazi Seyed Hossein; Dabirzadeh Mansour; Sadeghi Hamid Mirmohammad; Nilfrooshzadeh Mohammad Ali; Baghaei Mehdi
Volume 10, Issue 4 , 2007, , Pages 290-100
Abstract
Background and aim: Isfahan is one of the most important endemic areas of zoonotic cutaneous leishmaniasis (ZCL) in Iran. The objective of this study was to present different clinical pictures of ZCL and to identify the responsible Leishmania species using polymerase chain reaction (PCR). Materials and ...
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Background and aim: Isfahan is one of the most important endemic areas of zoonotic cutaneous leishmaniasis (ZCL) in Iran. The objective of this study was to present different clinical pictures of ZCL and to identify the responsible Leishmania species using polymerase chain reaction (PCR). Materials and methods: This cross-sectional, descriptive-analytic study was performed from September 2006 to February 2007, in skin Disease and Leishmania Research Center, which is a referal center for leishmaniasis. Among 440 suspected patients, Leishmania promastigotes were isolated from 31 atypical and 60 classic CL lesions and identified using Permissively Primed Polymorphic-PCR method. Results: From a total of 600 observed patients, 440 were parasitologically proved using direct smear, 409 patients (92.9%) showed typical clinical picture of volcano-shape and 31 (7.1%) of patients showed atypical forms. PCR method identified all isolates as L.major. Conclusion: ZCL lesions may present with various clinical manifestations in the same endemic area, which limits the identification of responsible parasite based on clinical features. The reason for diversities in clinical pictures are not yet known.
M Bakhshi Zadeh; SH Hejazi; M Baghaei; F Jafari; Z Ghayour; A Khamesi Pour
Volume 8, Issue 4 , 2005, , Pages 260-265
Abstract
Background an objective: Leishmaniasis is a common disease endemic in some parts of Iran. Chemical or physical treatments or a combination of both are used for treatment of the disease. Nitric oxide (NO) is important for healing of leishmaniasis in human and animal. This study was designed to evaluate ...
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Background an objective: Leishmaniasis is a common disease endemic in some parts of Iran. Chemical or physical treatments or a combination of both are used for treatment of the disease. Nitric oxide (NO) is important for healing of leishmaniasis in human and animal. This study was designed to evaluate the beneficial effects of a NO releasing cream on cutaneous leishmaniasis in an animal model. Materials and Methods: Balb/c mice were infected with leishmania major by injecting promastigotes into the base of tails of mice to induce the lesion. Then the animals were divided into 3 groups (Control, placebo and treatment). Mice were treated with the drugs one time daily. The diameter of lesions were measured on days 0, 5, 10, 15, 20, 25, and 30 after the appearance of the lesions. Data were analyzed using one-way ANOVA test and (P<0.05) considered as significant. Results: The diameter of lesions were significantly reduced in 15, 20, 25 and 30 day in NO cream treated animals compared to control and placebo groups (P<0.05). Conclusion: NO releasing compounds may be effective in the treatment of leishmaniasis.
MA Nilforoush Zadeh; F Jaffari; B Malek Afzali
Volume 7, Issue 3 , 2004, , Pages 136-139
Abstract
Background: In spite of different methods of treatment, there is not a simple, safe and complete curative treatment for cutaneous Leishmaniasis (CL), yet. Objective: To compare the efficacy of intralesional Glucantime injection alone, with the combined triple therapy of cryotherapy, paramomycin ointment ...
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Background: In spite of different methods of treatment, there is not a simple, safe and complete curative treatment for cutaneous Leishmaniasis (CL), yet. Objective: To compare the efficacy of intralesional Glucantime injection alone, with the combined triple therapy of cryotherapy, paramomycin ointment and intralesional Glucantime in the treatment of CL. Materials and methods: 157 patients with CL were randomly allocated into 2 groups, 81 patients in group 1 were injected with intralesional Glucantime (Twice a week up to healing to the lesions or maximum 6 weeks). 76 patients in group 2 were treated with Paramomycin ointment (15% in 10% urea, twice a day), cryotherapy (Maximum 3 times 2 weeks) apart and injection of intralesional Glucantime (Once a week), for the same period as group 1. Results: After 6 weeks, complete cure rate in group 2 (89.5%) was significantly more than group 1 (70.4%) (P<0.05). Conclusion: Our results indicating of more efficacy of the triple therapy is in accordance with the previous studies of combined cryotherapy and Paramomycin. It could be recommended as a better treatment modality for CL wherever possible.
MA Nilforoosh Zadeh; MR Reiss Zadeh; F Jafari
Volume 6, Issue 2 , 2003, , Pages 34-39
Abstract
Background: An easy and effective topical treatment is not yet available for cutaneous leishmaniasis. Objectives: To compare the effect of topical trichloroacetic acid (TCA) and intralesional glucantime injection in the treatment of acute wet cutaneous leishmaniasis. Patients and Methods: Eighty patients ...
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Background: An easy and effective topical treatment is not yet available for cutaneous leishmaniasis. Objectives: To compare the effect of topical trichloroacetic acid (TCA) and intralesional glucantime injection in the treatment of acute wet cutaneous leishmaniasis. Patients and Methods: Eighty patients with clinical diagnosis of wet cutaneous leishmaniasis in the age range of 5 to 75 years were recruited in this open clinical trial. Seven patients were withdrawn during the trial. In TCA group, 38 patients were treated three times (Every 2 weeks) with 50% TCA. In control group, 35 patients received intralesional glucantime injection weekly until healing or for a maximum of 6 weeks. All patients were followed for 3 months after last treatment. Results: After four weeks of treatment, 20 patients (52.6%) in TCA group and 17 patients (48.5%) in glucantime group, and after six weeks, 68% and 65.7% of patients in each respective group were completely cured. There was no important side effect in any groups. Conclusion: The nearly equal efficacy of TCA peeling and intralesional glucantime injection in the treatment of cutaneous leishmaniasis suggests that 50% TCA could be considered as a possible efficient therapeutic alternative in the management of this disease.
H Mortazavi; A Khamesipour; Z Hallaji; H Bakhshi; A Miramin Mohammadi
Volume 5, Issue 4 , 2002, , Pages 3-9
Abstract
Background: Cutaneous leishmaniasis (CL) is a self-healing disease, but due to unknown causes, a few cases of CL could get a chronic or non-healing course. These cases of chronic and recurrent leishmaniasis are defined as non-healing. Objectives: Comparison of the production of interferon-γ (IFN-γ) ...
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Background: Cutaneous leishmaniasis (CL) is a self-healing disease, but due to unknown causes, a few cases of CL could get a chronic or non-healing course. These cases of chronic and recurrent leishmaniasis are defined as non-healing. Objectives: Comparison of the production of interferon-γ (IFN-γ) and Leishmanin skin test (LST) between non-healing and healed patients of CL. Patients and Methods: Fifteen patients with non-healing CL suffering for more than two years, and eight individuals cured from CL were enrolled in this study. The rate of IFN-γ production by peripheral blood mononuclear cells assessed by ELISA and results of LST were compared in both groups. Results: The mean level of the IFN-γ production in non-healing patients and cured individuals were 729 pg/ml, and 4229 pg/ml, respectively (T- test, P<0.01). Four patients in non-healing group had negative LST and all cured patients had positive LST. Conclusion: The low level of the IFN-γ in non-healing patients and high level of IFN-γ in healed individuals are in favour of the lack of TH1 response, which is usually seen in healed patients. Comparing the results of LST between two groups is not conclusive.
MA Mapar; H Kavoosi; MA Dabbagh
Volume 4, Issue 4 , 2001, , Pages 23-28
Abstract
Background: Cutaneous leishmaniasis (CL) is a common cutaneous disease in the middle-east countries such as Iran. Khoozestan is an endemic area for it. The importance of this disease is in the formation of an ugly scar on the face, which damages beauty. There hasn’t been any effective topical treatment ...
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Background: Cutaneous leishmaniasis (CL) is a common cutaneous disease in the middle-east countries such as Iran. Khoozestan is an endemic area for it. The importance of this disease is in the formation of an ugly scar on the face, which damages beauty. There hasn’t been any effective topical treatment for this disease yet. Objective: To assess the effect of topical opium in the treatment of CL. Patients and Methods: A double blind, placebo controlled study was performed in Ahwaz during 1378 and 1379. 96 patients were included in this study and treated with a topical preparation of opium or placebo. The inclusion criteria for patient were: age more than 2 years, number of lesion less than 6, duration of disease less than 3 months, not using any drug with anti-leishmaniasis effect and positive direct smear. Pregnant or nursing patients were excluded. Results: From 58 patients who completed the study, 34 patients were given topical opium, 5 (4.2%) of them got cured. From 24 patients who were given placebo, only 1 (4.2%) patient got cured. This study did not show a significant difference between response to drug and placebo (P=0.12, chi-square test). Conclusion: From this study suggested that high concentration of topical opium or combination of topical opium with other material to be carried out.
Z Eslami
Volume 2, Issue 3 , 1999, , Pages 31-35
Abstract
Among the countless examples of interspecific interactions in biology, surely non-could be more interesting than which established between host animals and their specific parasites. The members of the genus Leishmania are peculiar obligate intracellular protozoans in that they proliferate in the enzyme ...
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Among the countless examples of interspecific interactions in biology, surely non-could be more interesting than which established between host animals and their specific parasites. The members of the genus Leishmania are peculiar obligate intracellular protozoans in that they proliferate in the enzyme rich phagolysosomes, an organelle which is essential component of all defence reactions of animals. These parasites are responsible for considerable morbidity and mortality worldwide and have, consequently, been the subject of much study, which has had the underlying objective of discovering the means of controlling these organisms. In this article some immunobiological aspects of leishmaniasis will be reviewed.
افسانه علوی; ایرج اسفندیارپور
Volume 1, 3-4 , 1998, , Pages 29-33
Abstract
Cutaneous leishmaniasis caused by leishmania tropica is endemic in Iran. Kerman is the fifth most infected foci of dry type of cutaneous leishmaniasis after Tehran, Mashhad, Naishabor and Shiraz. We studied the clinical features of this disease in 664 patients referred to the dermatology and private ...
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Cutaneous leishmaniasis caused by leishmania tropica is endemic in Iran. Kerman is the fifth most infected foci of dry type of cutaneous leishmaniasis after Tehran, Mashhad, Naishabor and Shiraz. We studied the clinical features of this disease in 664 patients referred to the dermatology and private clinic during the period March 1992 to March 1993 in Kerman. Females were dominated. The disease was more frequent below 10 years of age (50%). Papule and plaque were the most common clinical presentations of the disease followed by papule+plaque. The face was the most frequent site of involvement (30%); followed by right and left upper extremities. The trunk was the least common site (0.4%). Many of the patients were presented with one lesion, and the highest number of lesions in one patient was ten. The highest number of patients came with acute leishmaniasis (Duration of disease less than 1 year) and few patients with chronic from (Duration of disease more than 1 year).
