Treatment of cutaneous leishmaniasis with photodynamic therapy: The first case report from Khyber Pakhthunkhwa (KPK), Swat Pakistan
Keywords:Cutaneous leishmaniasis, photodynamic therapy, pentavalent antimoniate, photosensitizer, methylaminolevulinate
AbstractCutaneous Leishmaniasis (CL), the most common subtype of leishmaniasis, is a vector borne disease transmitted by sand fly. Herein, we report a case of CL being treated for the first time with photodynamic therapy (PDT) in KPK, Pakistan. A 55-year-old female patient presented with a single chronic disfiguring ulcerated lesion on the chin. The patient had received pentavalent antimoniate for the last 2 years, with no satisfactory outcome. We treated the patient with methylaminolevulinate based PDT and observed complete response after three sessions of the PDT treatment, each with a light energy dose of 75 J/cm2. The patient has remained disease-free for over 2 years. This study demonstrates the promising role of PDT in the treatment of CL.
Durrani, A. Z., H. Z. Durrani, and N. Kamal. 2012. Prevalence of Leishmania in sand fly in Pakistan. Pak. J. Zool. 44: 61–65.
Durrani, A. Z., H. Z. Durrani, N. Kamal, and N. Mehmood. 2011. Prevalence of cutaneous Leishmaniasis in humans and dogs in Pakistan. Pak. J. Zool. 43: 263–271.
Cruz I, Millet A, Carrillo E, Chenik M, Salotra P, Verma S, et al. “An approach for interlaboratory comparison of conventional and real-time PCR assays for diagnosis of human Leishmaniasis” . Exp Parasitol. 2013;134(3):281–289. https://doi: 10.1016/j.exppara.2013.03.026.
Gawade, S., M. Nanaware, R. Gokhale, and P. Adhav. 2012. Visceral Leishmaniasis: a case report. Australas. Med. j. 5: 130–134.
World Health Organization. Investing to overcome the global impact of neglected tropical diseases: third WHO report on neglected diseases 2015. Geneva: World Health Organization; 2015.
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.
Al-Jaser, M., A. El-Yazigi, and S. L. Croft. 1995. Pharmacokinetics of antimony in patients treated with sodium stibogluconate for cutaneous Leishmaniasis. Pharm. Res. 12:113–116.
M.A. MacCormack, Photodynamic therapy in dermatology: an update on applications and outcomes, Semin. Cutan. Med. Surg. 27 (2008) 52–62.
Gardlo K, et al. Treatment of cutaneous Leishmaniasis by photodynamic therapy J Am Acad Dermatol. 2003 Jun;48(6):893-6.
Sundar S, More DK, Singh MK, Singh VP, Sharma S, Makharia A, et al. Failure of pentavalent antimony in visceral Leishmaniasis in India: report from the center of the Indian epidemic. Clin Infect Dis. 2000;31:1104–7.
Sundar S, Thakur BB, Tandon AK, Agrawal NR, Mishra CP, Mahapatra TM, et al. Clinico-epidemiological study of drug resistance in Indian kala-azar. BMJ. 1994;308:307.
Thakur CP, Kumar M, Kumar P, Mishra BN, Pandey AK. “Rationalisation of regimens of treatment of kala-azar with sodium stibogluconate in India: a randomised study”. Br Med J (Clin Res Ed) 1988;296:1557–61.
Thakur CP, Kumar M, Pandey AK. Evaluation of efficacy of longer durations of therapy of fresh cases of kala-azar with sodium stibogluconate. Indian J Med Res. 1991;93:103–10.
Jha TK, Singh NK, Jha SN. Therapeutic use of sodium stibogluconate in kala-azar from some hyperendemic districts of N.Bihar, India (Abstract) J Assoc Physicians India. 1992;40:868.
Sundar S, Singh VP, Sharma S, Makharia MK, Murray HW. “Response to interferon-ά plus pentavalent antimony in Indian visceral Leishmaniasis”, J Infect Dis. 1997;176:1117–9.