Treatment of cutaneous leishmaniasis with long-pulsed Nd:YAG laser in comparison with intralesional sodium stibogluconate or ciprofloxacin
DOI:
https://doi.org/10.66344/jpad.34.4.2024.2725Keywords:
Cutaneous Leishmaniasis, Nd:YAG Laser, Sodium Stibogluconate, Ciprofloxacin, Treatment ComparisonAbstract
Objective Cutaneous leishmaniasis (CL), a significant public health issue, is caused by a parasitic infection. This research aimed to assess the effectiveness and safety of long-pulsed Nd:YAG laser therapy in treating CL, and to compare its outcomes with treatments using intralesional sodium stibogluconate and 0.2% ciprofloxacin. Â Methods In this study, 26 patients with a total of 73 cutaneous leishmaniasis lesions were divided into three groups for treatment. Group one, with 28 lesions, received long-pulsed Nd:YAG laser therapy. Group two, comprising 19 lesions, was treated with intralesional sodium stibogluconate, while group three, with 26 lesions, received intralesional 0.2% ciprofloxacin. Treatment efficacy was categorized into four levels: mild, moderate, marked, and complete clinical response. Treatments occurred bi-weekly over six weeks, followed by a three-month post-treatment follow-up to check for any complications. Â Results Twenty-six patients with 73 cutaneous leishmaniasis lesions participated. Among them, 18 (69.2%) were male, and 8 (30.8%) were female. The treatment success rates were 82.1% for long-pulsed Nd:YAG laser, 78.9% for intralesional sodium stibogluconate, and 84.6% for intralesional ciprofloxacin. Throughout the treatment and follow-up period, no significant side effects or complications were observed in any of the three groups. Â Conclusion Long-pulsed Nd:YAG laser seems to be comparable to both intralesional sodium stibogluconate and intralesional 0.2% ciprofloxacin in the treatment of cutaneous leishmaniasis. ÂReferences
Siadat HA, Zolfaghari A, Shahmoradi Z, et al. Application of laser for treatment of cutaneous leishmaniasis: a review of literature. Lasers Med Sci. 2020;35(7):1451-1457.
Sharquie KE, Noaimi AA, Al-Ghazzi AG. Treatment of cutaneous leishmaniasis by topical 25% podophyllin solution (single, blinded, therapeutic, controlled study). J Dermatol Dermatol Surg. 2015;19(2):108-113.
Bravo FG. Protozoa and Worms. In: Bolognia JL, Schaffer JV, Cerroni L (Eds). Dermatology. 4th ed. Elsevier; 2018.1470-1502.
Downing C, Tyring S. Parasitic diseases. In: Griffiiths CE, Barker J, Bleiker T (Eds). Rook's textbook of dermatology. 9th ed. West Sussex: Wiley Blackwell; 2016.1016-1069.
Naif A, Hasan H, Kadhim K. Metronidazole versus Pentostam for treatment of cutaneous leishmaniasis. Gazz Med Ital. 2018;177(11):611-616.
Al-Heany AR, Sharquie KE, Al-Najar SA, et al. Cutaneous leishmaniasis: Comparative techniques for diagnosis. IOSR J Dent Med Sci. 2014;13:33-7.
Malek JM, Ghosn SH. Leishmaniasis and other protozoan infections. In: Goldsmith LA, Katz SI, Gilchrest BA, et al (Eds). Fitzpatrick's dermatology in general medicine. 8th ed. New York: The McGraw-Hill Companies; 2012:2526-2544.
Sharquie KE, Noaimi AA, Saleh BA. Cutaneous leishmaniasis as imitator of skin diseases and a diagnostic challenge. J Cosmet Dermatol Sci Appl. 2018;8:158-177.
Eiras DP, Kirkman LA, Murray HW. Cutaneous leishmaniasis: current treatment practices in the USA for returning travelers. Curr Treat Options Infect Dis. 2015;7(1):52–62.
Waller DG, Sampson AP (Eds). Medical pharmacology and therapeutics. 5th ed. Elsevier; 2018.
Aronson N, Herwaldt BL, Libman M, 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). Am J Trop Med Hyg. 2017;96(1):24-45.
Al Hamdi K, Awad AH, Moker HM. Evaluation of intralesional 0.2% ciprofloxacin as a treatment for cutaneous leishmaniasis. East Mediterr Health J. 2010;16(1):89-93.
Sharquie KE. A new intralesional therapy of cutaneous leishmaniasis with hypertonic sodium chloride solution. J Dermatol. 1995;22(10):732-7.
Sharquie KE, Najim RA, Farjou IB. A comparative control trail of intralesional administrated zinc sulfate, hypertonic saline chloride and pentavalent antimony compound against acute cutaneous leishmaniasis. Clin Exp Dermatol. 1997;22(4):169-73.
Al-Waiz M, Sharquie KE, Al-Assir M. Treatment of cutaneous leishmaniasis by intralesional metronidazole. Saudi Med J. 2004;25:1512-3.
Sharquie KE, Noaimi AA, Sharara ZA, et al. Topical therapy of acute cutaneous leishmaniasis using zinc sulphate solution 25% versus podophyllin solution 25%. J Cosmet Dermatol Sci Appl. 2017;7(03):258.
Kaufman J. Nd:YAG laser. In: Bard S, Goldberg DJ (Eds). Laser treatment of vascular lesions. Basel: Karger; 2014:94–106.
Steiner R. Basic laser physics. In: Raulin C, Karsai S (Eds). Laser and IPL technology in dermatology and aesthetic medicine. Springer-Verlag Berlin Heidelberg; 2011:2-22.
Sabaa HS, Zghair KH, Mohammed NR, et al. The effect of Nd:YAG lasers on leishmania donovani promastigotes. World J Exp Biosci. 2016;4:25-28.
Omidian M, Jadbabaei M, Omidian E, et al. The effect of Nd:YAG laser therapy on cutaneous leishmaniasis compared to intralesional meglumine antimoniate. Postepy Dermatol Alergol. 2019;36(2):227–231.
Yanik M, Gurel MS, Simsek Z, et al. The psychological impact of cutaneous leishmaniasis. Clin Exp Dermatol. 2004;29(5):464-7.
Asilian A, Sadeghinia A, Faghihi G, et al. Comparative study of the efficacy of combined cryotherapy and intralesional meglumine antimoniate (Glucantime®) vs. cryotherapy and intralesional meglumine antimoniate (Glucantime®) alone for the treatment of cutaneous leishmaniasis. Int J Dermatol. 2004;43(4):281-3.
Salmanpour R, Razmavar MR, Abtahi N. Comparison of intralesional meglumine antimoniate, cryotherapy and their combination in the treatment of cutaneous leishmaniasis. Int J Dermatol. 2006;45(9):1115-6.
Al-Sabak H, Al-Dhalimi MA, Ali WA. Treatment of verruca vulgaris with long pulsed Nd:YAG laser 1064 nm in Iraqi patients. Kufa J Nurs Sci. 2019;9(1):1-10.
El-Sayed M, Anwar AE. 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. J Eur Acad Dermatol Venereol. 2010;24(3):335-40.
Sharquie KE, Al-Talib KK, Chu AC. Intralesional therapy of cutaneous leishmaniasis with sodium stibogluconate antimony. Br J Dermatol. 1988;119(1):53-7.
Ghos S. Evaluation of sodium stibogluconate in treatment of cutaneous leishmaniasis. Curr Med Res Opin. 1978;6:280-283.
Faris RM, Zorallah JS, Khoja TA, et al. Intralesional treatment of cutaneous leishmaniasis with sodium stibogluconate antimony. Int J Dermatol. 1993;32:610-612.
Arshad AR, Arshad A. Intralesional ciprofloxacin for cutaneous leishmaniasis: Comparison with meglumine antimoniate. Pak J Med Sci. 2011;27(3):566-568.
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