Efficacy of Systemic Treatment for Leishmania tropica Cutaneous Leishmaniasis
Keywords:Leishmania tropica, liposomal amphotericin B, L-AmB, sodium stibogluconate, cutaneous leishmaniasis, systemic treatment
The effectiveness of systemic treatment for Leishmania tropica cutaneous leishmaniasis remains unclear. The purpose of the study is to evaluate the efficacy and safety of systemic treatments for L. tropica cutaneous leishmaniasis. This retrospective study was performed in 114 patients. Systemic treatments included liposomal amphotericin B and sodium stibogluconate. All patients underwent systemic treatment for L. tropica cutaneous leishmaniasis. Favourable treatment responses were recorded in 72.5% and 70.2% of the patients in the liposomal amphotericin B and sodium stibogluconate groups, respectively; 25.3% and 46% of those in the liposomal amphotericin B and sodium stibogluconate groups respectively, experienced at least one adverse effect. Lesions in cartilaginous areas were associated with higher treatment failure. Prior topical or systemic treatment increased the chance of future systemic treatment success. Liposomal amphotericin B was associated with a shorter intravenous treatment duration and better safety profile. Thus, liposomal amphotericin B is the treatment of choice for L. tropica cutaneous leishmaniasis.
Alvar J, Velez ID, Bern C, Herrero M, Desjeux P, Cano J, et al. Leishmaniasis worldwide and global estimates of its incidence. PLoS ONE 2012; 7: e35671.
Pigott DM, Golding N, Messina JP, Battle KE, Duda KA, Balard Y, et al. Global database of leishmaniasis occurrence locations, 1960-2012. Sci Data 2014; 1: 140036.
Jaffe CL, Baneth G, Abdeen ZA, Schlein Y, Warburg A. Leishmaniasis in Israel and the Palestinian Authority. Trends Parasitol 2004; 20: 328-332.
Schlein Y, Warburg A, Schnur LF, Le Blancq SM, Gunders AE. Leishmaniasis in Israel: reservoir hosts, sandfly vectors and leishmanial strains in the Negev, Central Arava and along the Dead Sea. Trans R Soc Trop Med Hyg 1984; 78: 480-484.
Jacobson RL, Eisenberger CL, Svobodova M, Baneth G, Sztern J, Carvalho J, et al. Outbreak of cutaneous leishmaniasis in northern Israel. J Infect Dis 2003; 188: 1065-1073.
Hepburn NC. Cutaneous leishmaniasis. Clin Exp Dermatol 2000; 25: 363-370.
Klaus S, Frankenburg S. Cutaneous leishmaniasis in the Middle East. Clin Dermatol 1999; 17: 137-141; discussion 105-136.
Momeni AZ, Aminjavaheri M. Treatment of recurrent cutaneous leishmaniasis. Int J Dermatol 1995; 34: 129-133.
Moskowitz PF, Kurban AK. Treatment of cutaneous leishmaniasis: retrospectives and advances for the 21st century. Clin Dermatol 1999; 17: 305-315.
Magill AJ, Grögl M, Gasser RA, Jr, Sun W, Oster CN. Visceral infection caused by leishmania tropica in veterans of Operation Desert Storm. N Engl J Med 1993; 328: 1383-1387.
Aronson N, Herwaldt BL, Libman M, Pearson R, Lopez-Velez R, Weina P, et al. Diagnosis and treatment of leishmaniasis: clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis 2016; 63: e202-e264.
Heras-Mosteiro J, Monge-Maillo B, Pinart M, Lopez Pereira P, Reveiz L, Garcia-Carrasco E, et al. Interventions for Old World cutaneous leishmaniasis. Cochrane Database Syst Rev 2017; 12: CD005067.
Solomon M, Schwartz E, Pavlotsky F, Sakka N, Barzilai A, Greenberger S. Leishmania tropica in children: a retrospective study. J Am Acad Dermatol 2014; 71: 271-277.
Herwaldt BL, Berman JD. Recommendations for treating leishmaniasis with sodium stibogluconate (Pentostam) and review of pertinent clinical studies. Am J Trop Med Hyg 1992; 46: 296-306.
Solomon M, Pavlotsky F, Leshem E, Ephros M, Trau H, Schwartz E. Liposomal amphotericin B treatment of cutaneous leishmaniasis due to Leishmania tropica. J Eur Acad Dermatol Venereol 2011; 25: 973-977.
Wortmann G, Zapor M, Ressner R, Fraser S, Hartzell J, Pierson J, et al. Lipsosomal amphotericin B for treatment of cutaneous leishmaniasis. Am J Trop Med Hyg 2010; 83: 1028-1033.
Kamink S, Masih B, Ali N, Ullah A, Khan SJ, Ashraf S, et al. Effectiveness of miltefosine in cutaneous leishmaniasis caused by Leishmania tropica in Pakistan after antimonial treatment failure or contraindications to first line therapy-A retrospective analysis. PLoS Negl Trop Dis 2021; 15: e0008988.
Monroy-Ostria A, Nasereddin A, Monteon VM, Guzmán-Bracho C, Jaffe CL. ITS1 PCR-RFLP diagnosis and characterization of leishmania in clinical samples and strains from cases of human cutaneous leishmaniasis in States of the Mexican Southeast. Interdiscip Perspect Infect Dis 2014; 2014: 607287.
Ponte-Sucre A, Gamarro F, Dujardin JC, Barrett MP, Lopez-Velez R, Garcia-Hernandez R, et al. Drug resistance and treatment failure in leishmaniasis: a 21st century challenge. PLoS Negl Trop Dis 2017; 11: e0006052.
Hadighi R, Mohebali M, Boucher P, Hajjaran H, Khamesipour A, Ouellette M. Unresponsiveness to Glucantime treatment in Iranian cutaneous leishmaniasis due to drug-resistant Leishmania tropica parasites. PLoS Med 2006; 3: e162.
Karamian M, Bojd MS, Salehabadi A, Hemmati M, Barati DA. Effectiveness of meglumine antimoniate against L. tropica in a recently emerged focus of cutaneous leishmaniasis in Birjand, eastern Islamic Republic of Iran. East Mediterr Health J 2015; 21: 280-286.
Purkait B, Kumar A, Nandi N, Sardar AH, Das S, Kumar S, et al. Mechanism of amphotericin B resistance in clinical isolates of Leishmania donovani. Antimicrob Agents Chemother 2012; 56: 1031-1041.
Mwenechanya R, Kovářová J, Dickens NJ, Mudaliar M, Herzyk P, Vincent IM, et al. Sterol 14α-demethylase mutation leads to amphotericin B resistance in Leishmania mexicana. PLoS Negl Trop Dis 2017; 11: e0005649.
Ollech A, Solomon M, Horev A, Reiss-Huss S, Ben-Amitai D, Zvulunov A, et al. Cutaneous leishmaniasis treated with miltefosine: a case series of 10 paediatric patients. Acta Derm Venereol 2020; 100: adv00322.
How to Cite
Copyright (c) 2022 Michal Solomon, Shoshana Greenberger, Maya Milner, Felix Pavlotzky, Aviv Barzilai, Eli Schwartz, Noa Hadayer, Sharon Baum
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work.
Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.