Abstract
Cutaneous leishmaniasis is endemic in Saudi Arabia and is a worldwide problem. In an attempt to reduce the side effects of parental drugs and keep costs low, this study evaluated intralesional sodium stibogluconate.
Seven hundred and ten (710) patients with the parasite demonstrated in smears from the lesion were enrolled. Sixty-four percent (64%) were less than 15 years of age. Seventy-three percent (73%) of the patients had one lesion and the mean number of lesions was 1.5. Sixty-eight percent (68%) of the lesions were on the face. Treatment consisted of injection with a fine insulin needle with 0.5-1 mL of the agent and repeated on alternate days for a total of eight injections. In those lesions complicated by infection or previous cautery or cryotherapy up to 24 injections were done. Secondarily infected lesions were first treated with systemic rifampin and/or topical antibiotic or ketoconazole.
Seventy-two percent (72%) of the treated lesions healed completely. Twenty-three and nine-tenths percent (23.9%) showed some improvement after 1 month of treatment. Resolution took 2 to 8 weeks depending on site. Of the 4.1% showing deterioration, all had been treated previously. Other than injection site pain there were no side effects except hyperpigmentation in 17%, all of whom received previous local treatment. This usually disappeared spontaneously.
The rapid response may be due to the direct application of the agent directly to the affected tissues.
Recently, this method of treatment has been recommended by the World Health Organization.
Conclusion: Intralesional sodium stibogluconate is safe and therapeutically effective.