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Cutaneous leishmaniasis treatment.

Philippe Minodier1, Philippe Parola

  • 1Pediatric Emergency Unit, CHU Nord, Chemin des Bourrelly, 13915 Marseille Cedex 20, France. philippe.minodier@ap-hm.fr

Travel Medicine and Infectious Disease
|April 24, 2007
PubMed
Summary
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Treatment for cutaneous leishmaniasis varies by causative species. While antimonials remain standard, newer options like paromomycin ointments and topical imiquimod show promise for specific Leishmania infections.

Area of Science:

  • Dermatology
  • Infectious Diseases
  • Parasitology

Background:

  • Cutaneous leishmaniasis (CL) presents diverse clinical manifestations and treatment responses based on the causative Leishmania species.
  • Antimonials (intralesional or systemic) are the established gold standard for CL treatment.
  • Emerging therapeutic strategies are being explored, particularly for CL, mirroring advancements in visceral leishmaniasis treatment.

Purpose of the Study:

  • To review and evaluate current and emerging therapeutic options for cutaneous leishmaniasis.
  • To highlight the species-specific efficacy of various treatment modalities for CL.
  • To identify alternative treatments for CL cases unresponsive to standard therapies.

Main Methods:

  • Literature review of studies on cutaneous leishmaniasis treatments.

Related Experiment Videos

  • Analysis of clinical trial data and in vitro/in vivo study findings.
  • Comparison of treatment efficacy across different Leishmania species and clinical presentations.

    • Main Results:

    • Paromomycin ointments demonstrate efficacy against Leishmania major, L. tropica, L. mexicana, and L. panamensis.
    • Topical paromomycin and imiquimod are options for localized Leishmania braziliensis infections.
    • Oral fluconazole and zinc sulfate are beneficial for L. major; azithromycin requires further human study.
    • Intramuscular pentamidine is crucial for Leishmania guyanensis CL; miltefosine and itraconazole show limited efficacy.
    • Liposomal amphotericin B is a potential alternative to antimony for South American CL with mucosal involvement.

    Conclusions:

    • Treatment selection for cutaneous leishmaniasis must be guided by the specific causative Leishmania species.
    • Several topical and oral agents offer promising alternatives or adjuncts to antimonials for various CL forms.
    • Further research is needed to establish the role of agents like azithromycin in human leishmaniasis treatment.
    • Liposomal amphotericin B presents a viable option for severe or mucosal CL, particularly in South America.