Combined intralesional and intramuscular sodium stibogluconate appears more effective in the treatment of localized cutaneous leishmaniasis lesions, An experimental study

Hamad Ayed Alfahaad

Abstract


Background Intralesional sodium stibogluconate (SSG) has become the first line therapy for localized cutaneous leishmaniasis (LCL). The objective of this study was to compare the efficacy of intralesional SSG given alone with that of intralesional SSG combined with intramuscular SSG.

 

Methods This randomized controlled intervention study was conducted at the Department of Dermatology, King Khalid Hospital in Najran, Saudi Arabia. A total of 40 patients with LCL were assigned randomly to Group-1 (n=20) or Group-2 (n=20). Group-1 received three injections of intralesional SSG on alternate days, while Group-2 received three injections of intralesional SSG similar to Group-1 and the rest of the calculated dose as a simultaneous intramuscular injection. Five treatment cycles were carried out through monthly follow-up visits during subsequent five months to assess the treatment outcome in both groups.

 

Results The patients in Group-2 showed overall better improvement than that of the patients in Group-1 in all treatment cycles. Most of the plaque lesions, multiple lesions and mucosal lesions were cured after 1 to 2 treatment cycles in Group-2, compared to the patients in Group-1 having similar lesions required 2 or more cycles for cure. The resultant scarring after healing among the patients in Group-2 was even and cosmetically more acceptable than that was observed among the patients in Group-1.

 

Conclusion Combination regimen of intralesional and intramuscular SSG appeared to be more effective than intralesional SSG given alone in the treatment of LCL.

 


Keywords


intralesional sodium stibogluconate, cutaneous leishmaniasis

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References


Abuzaid, A. A., Abdoon, A. M., Aldahan, M. A., Alzahrani, A. G., Alhakeem, R. F., Asiri, A. M., Alzahrani, M. H., Memish, Z. A. (2017). Cutaneous Leishmaniasis in Saudi Arabia: A Comprehensive Overview. Vector borne and zoonotic diseases (Larchmont, N.Y.), 17(10), 673-684.

− Dassoni, Federica & Abebe, Zerihun & Naafs, Bernard & Morrone, Aldo. (2012). Cutaneous and Mucocutaneous Leishmaniasis Resembling Borderline-tuberculoid Leprosy: A New Clinical Presentation?. Acta dermato-venereologica. 93. 10.2340/00015555-1338.

− E. Kellum, Robert. (1986). Treatment of cutaneous leishmaniasis with an intralesional antimonial drug (Pentosam). Journal of the American Academy of Dermatology. 15. 620-2. 10.1016/S0190-9622(86)70214-4.

− El-Sayed, Manal & Anwar, AE. (2010). Intralesional sodium stibogluconate alone or its combination with either intramuscular sodium stibogluconate or oral ketoconazole in the treatment of localized cutaneous leishmaniasis: A comparative study. Journal of the European Academy of Dermatology and Venereology : JEADV. 24. 335-40. 10.1111/j.1468-3083.2009.03417.x

− Jombo, Godwin & K. Gyoh, S. (2010). Unusual presentations of cutaneous leishmaniasis in clinical practice and potential challenges in diagnosis: A comprehensive analysis of literature reviews. Asian Pacific Journal of Tropical Medicine. 3. 917-921. 10.1016/S1995-7645(10)60220-9.

− Mohammad Kashif, Partha P. Manna, Yusuf Akhter, Mohammed Alaidarous and Abdur Rub “Screening of Novel Inhibitors Against Leishmania donovani Calcium ion Channel to Fight Leishmaniasis”, Infectious Disorders - Drug Targets (2017) 17: 120. https://doi.org/10.2174/1871526516666161230124513

− Negi AK, Sharma NL, Mahajan VK, Ranjan N & Kanga AK. (2007). Comparative efficacy of intralesional sodium stibogluconate (SSG) alone and its combination with intramuscular SSG to treat localized cutaneous leishmaniasis: Results of a pilot study. Indian journal of dermatology, venereology and leprology. 73. 280. 10.4103/0378-6323.33651.

− Sharquie, K. , AL-Talib, K. and Chu, A. (1988), Intralesional therapy of cutaneous leishmaniasis with sodium stibogluconate antimony. British Journal of Dermatology, 119: 53-57. doi:10.1111/j.1365-2133.1988.tb07100.x

− Tallab T, Bahamdam K, Mirdad S, Johargi H, et al. (1996), Cutaneous leishmaniasis: Schedules for intralesional treatment with sodium stibogluconate. Int J Dermatol ; 35:594–597 [PubMed]

− Torres-Guerrero, E., Quintanilla-Cedillo, M. R., Ruiz-Esmenjaud, J., & Arenas, R. (2017). Leishmaniasis: a review. F1000Research, 6, 750. doi:10.12688/f1000research.11120.1

− van Griensven, J., Gadisa, E., Aseffa, A., Hailu, A., Beshah, A. M., & Diro, E. (2016). Treatment of Cutaneous Leishmaniasis Caused by Leishmania aethiopica: A Systematic Review. PLoS neglected tropical diseases, 10(3), e0004495. doi:10.1371/journal.pntd.0004495

− World Health Organization. Epidemiological aspects. In control of the leishmaniasis, WHO Tech Rep Ser.793. World Health Organization: Geneva; 1990. p. 41-6.


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