Triple therapy for acute and chronic cutaneous leishmaniasis using oral zinc sulfate, oral ketoconazole and topical podophyllin
Triple therapy for cutaneous leishmaniasis
DOI:
https://doi.org/10.66344/jpad.v32i3.1955Abstract
Objective To determine the efficacy of triple therapy using oral ketoconazole, oral zinc sulfate plus topical podophyllin in the management of cutaneous leishmaniasis.
Methods This is a prospective, therapeutic study that was performed during the period, March 2019 to December 2021 where 230 patients with acute and chronic cutaneous leishmaniasis were recruited. Smear and histopathology were used to confirm the diagnosis. All cases were treated by oral zinc sulfate (5-10 mg/kg/day in divided doses), oral ketoconazole given 200mg twice a day for adults and 100mg for young children and 50-75 mg a day for infants according to the body weight (3.3-6.6 mg/kg/day). Topical 25% podophyllin solution was applied once a week. The duration of therapy was continued up to 6 weeks with every two weeks follow-up until complete cure, then followed every month for the next three months. To assess response to treatment, Sharquie’s modified Leishmania scoring was applied.
Results The analysis of 230 patients with cutaneous leishmaniasis showed the age of presenting patients ranged from 6 months-60years. The mean age was 27 years with 120 (52.17%) males and 110 (47.82%) females. Response began after one week, clearance was seen after 6 weeks. The cure rate was 99%. No serious adverse effects were noticed. Gastric irritation was seen in some patients receiving zinc sulfate and skin burning in some patients using podophyllin.
Conclusion Triple therapy of cutaneous leishmaniasis using oral ketoconazole, oral zinc sulfate plus topical podophyllin was effective in treatment of acute and chronic leishmaniasis. No important systemic and local adverse reactions were recorded.
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