Complete Resolution of Cutaneous Leishmaniasis With a Novel Topical Combination Therapy: A Case Series

Cutaneous leishmaniasis (CL) remains a therapeutic challenge in endemic regions, with 600,000-1 million new cases annually facing limited treatment options. We present a case series evaluating an innovative topical combination therapy for acute-phase CL in Shiraz, Iran. Three treatment-naïve patients (45-year-old female with forearm lesions, 18-year-old male with foot involvement, and 52-year-old female with hand lesions) received daily applications of a novel solution containing ciprofloxacin, ketoconazole, and metronidazole for 30 days, followed by alpha hydroxy acid for scar rehabilitation. Remarkably, all patients demonstrated complete lesion resolution and significant cosmetic improvement without treatment-related adverse events. This well-tolerated regimen offers several advantages over conventional systemic antimonials, including reduced toxicity, improved accessibility, and simplified administration. Our findings support the growing body of evidence for topical CL treatments, offering a potentially safer, more accessible option that warrants further clinical investigation in endemic regions. This study highlights the importance of developing targeted therapies that consider both clinical efficacy and practical implementation challenges in resource-limited settings.