Efficacy of oral zinc sulphate compared with intralesional meglumine antimoniate injection (glucantime) in the treatment of cutaneous leishmaniasis

Authors

  • Farah Sattar
  • Shamshad Akram
  • Aliya Akhtar Nishtar Medical University,Multan
  • Uzma Almas
  • Raheel Tahir
  • Shahid Nawaz

Keywords:

Cutaneous leishmaniasis (CL), zinc sulphate, meglumine antimoniate (MA).

Abstract

Introduction Leishmaniasis comprises of group of human infections which range in severity of disease from spontaneously healing skin ulcer to overwhelming systemic illness. Approximately 12 million patients are reported all over the world every year with this disease and it is associated with significant increase in morbidity.  This study was conducted to compare the effectiveness of oral zinc sulphate with intralesional meglumine antimoniate injection in the treatment of cutaneous leishmaniasis. Objective To compare the efficacy of oral zinc sulphate with intralesional meglumine antimoniate injection in patients presenting with cutaneous leishmaniasis at a tertiary care hospital. Subjects and Methods The randomized control trial was carried out in the Outpatient Department of Dermatology, Nishtar Hospital Multan from 1-6-2016 to 30-11-2016. A total of 68 patients with cutaneous leishmaniasis were enrolled through Outpatient Department of Dermatology. The disease was diagnosed on clinical features with appearance of a papule or nodule at the feeding site of sandfly. Results Mean age of the patients presenting with cutaneous leishmaniasis in group A was 26.76±16.71 years and in group B 26.02±15.15 years. Males were (52.9% vs. 58.8%) in group A and B respectively while females were (47.1% vs. 41.2%) in group A and B respectively. In group A, 30 patients (88.2%) showed effective response to therapy and 4 patients (11.8%) showed ineffective response. Effective response in terms of complete cure was seen in 20 patients (66.7%) while effective response in terms of partial improvement was seen in 10 patients (33.3%). In group B, effective response was seen in 26 patients (76.5%), with complete cure in 14 patients (53.8%) and partial improvement in 12 (46.1%) patients. Ineffective response was seen in 8 (23.5%) patients. Conclusion There is no significant difference in the treatment of cutaneous leishmaniasis with oral zinc sulphate and intralesional meglumine antimoniate injection. 

Author Biography

Aliya Akhtar, Nishtar Medical University,Multan

Assistant Professor Dermatology,DermatologyDep;artment,Nishtar Medical University,Multan.

References

Desjeux P. Leishmaniasis: current situation and new perspective. Comp Immunol Microbiol Infect Dis 2004; 27: 305-18.

Davies CR. Leishmaniasis: new approaches to disease control. BMJ 2003; 326: 377-82.

Crespo-Erchiga V, Florencio VD. Malassezia yeasts and pityriasis versicolor. Curr Opin Infect Dis 2006; 19(2): 139-47.

Bhutto AM, Soomro RA, Nonaka S, Hashiguchi Y. Detection of new endemic areas of cutaneous leishmaniasis in Pakistan. Int J Dermatol 2003; 42: 543-8.

Ayub S, Gramiccia M, Khalid M, Mujtaba G, Bhutta RA. Cutaneous leishmaniasis in Multan. J Pak Med Assoc 2003; 53: 445-7.

Iftikhar N, Bari I, Ejaz A. Rare variants of cutaneous leishmaniasis: whitlow, paronychia, and sporotrichoid. Int J Dermatol 2003; 42: 807-9.

Morishita N, Sei Y, Sugita T. Molecular analysis of malassezia microflora from patients with pityriasis versicolor. Mycopathologia 2006; 161(2): 61-5.

Piscopo TV, Mallia, Azzopardi C. Leishmaniasis. Postgrad Med J 2007; 83: 649-57.

Lurati M, Baudraz-Rosselet F, Vernez M, Spring P, Bontems O, Fratti M, et al. Efficacious treatment of non-dermatophyte mould onychomycosis with topical amphotericin B. Dermatol 2011; 223: 289-92.

Asilian A, Davami M. Comparison between the efficacy of photodynamic therapy and topical paromomycin in the treatment of old world cutaneous leishmaniasis. Clin Exp Dermatol 2006; 31: 634-7.

Larbi EB, al-Khawajah A, al-Gindan Y, Jain S, Abahusain A, al-Zayer A. A randomized, double-blind, clinical trial of topical clotrimazole versus miconazole for treatment of cutaneous leishmaniasis in the eastern province of Saudi Arabia. Am J Trop Med Hyg 1995; 52: 166-8.

Firooz A, Khatami A, Khamesipour A, Nassiri-Kashani M, Behnia F, Nilforoushzadeh M, et al. Intralesional injection of 2% zinc sulfate solution in the treatment of acute old world cutaneous leishmaniasis. J Drug Dermatol 2005; 4: 73-7.

Zerehsaz F, Salmanpour R, Handjani F, Ardehali S, Panjehshahin MR, Tabei SZ, et al. A double-blind randomized clinical trial of a topical herbal extract (Z-HE) vs. systemic meglumine antimoniate for the treatment of cutaneous leishmaniasis in Iran. Int J Dermatol 1999; 38: 610-2.

Ananda-Rajah MR, Grigg A, Slavin MA. Making sense of posaconazole therapeutic drug monitoring. Curr Opin Infect Dis 2012; 25: 605-11.

Iraji F, Vali A, Asilian A, Shahtalebi MA, Momeni AZ. Comparison of intralesionally injected zinc sulfate with meglumine antimoniate in the treatment of acute cutaneous leishmaniasis. Dermatology 2004; 209: 46-9.

Moodahadu-Bangera LS, Martis J, Mittal R, Krishnankutty B, Kumar N, Bellary S, et al. Eberconazole--pharmacological and clinical review. Indian J Dermatol Venereol Leprol 2012; 78: 217-22

Türel O. Newer antifungal agents. Expert Rev Anti Infect Ther 2011; 9: 325-38.

Sharquie KE, Najim RA, Farjou IB. A comparative controlled trial of intralesionally administered zinc sulphate, hypertonic sodium chloride and pentavalent antimony compound against acute cutaneous leishmaniasis. Clin Exp Dermatol 1997; 22: 169-73.

Sharquie KE, Najim RA, Farjou IB. Oral zinc sulphate in the treatment of acute cutaneous leishmaniasis. Clin Exp Dermatol 2001; 26: 21-6.

Iraji F, Vali A, Asilian A. Comparison of intralesionally injected zinc sulfate with meglumine antimoniate in treatment of acute cutaneous leishmaniasis. Dermatol 2004; 209: 46-9.

Das S, Barbhuniya JN, Biswas I, Bhattacharya S, Kundu PK. Studies on comparison of the efficacy of terbinafine 1% cream and butenafine 1% cream for the treatment of Tinea cruris. Indian Dermatol Online J 2010; 1: 8-9.

Keshtkar-Jahromi M, McTighe AH, Segalman KA, Fothergill AW, Campbell WN. Unusual case of cutaneous and synovial Paecilomyceslilacinus infection of hand successfully treated with voriconazole and review of published literature. Mycopathologia 2012; 174: 255-8.

Yazdanpanah MJ, Mostofi K, Soleimani M, Ebrahimirad M. Oral administration of zinc sulphate in treatment of acute cutaneous leishmaniasis. IRCMJ 2007; 9: 205-8.

YazdanPanah MJ, Mostoufi SK, Soleimani M. Oral zinc sulfate in the treatment of acute cutaneous leishmaniasis. Iranian J Dermatol 2003; 2: 20-4.

Downloads

Published

2020-08-07

How to Cite

1.
Sattar F, Akram S, Akhtar A, Almas U, Tahir R, Nawaz S. Efficacy of oral zinc sulphate compared with intralesional meglumine antimoniate injection (glucantime) in the treatment of cutaneous leishmaniasis. J Pak Assoc Dermatol [Internet]. 2020Aug.7 [cited 2025Jan.26];30(1):111-6. Available from: https://www.jpad.com.pk/index.php/jpad/article/view/1338

Issue

Section

Original Articles

Most read articles by the same author(s)