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Farajzadeh S, Heshmatkhah A, Vares B, Mohebbi E, Mohebbi A, Aflatoonian M, Eybpoosh S, Sharifi I, Aflatoonian MR, Shamsi Meymandi S, Fekri AR, Mostafavi M. Topical terbinafine in the treatment of cutaneous leishmaniasis: triple blind randomized clinical trial. J Parasit Dis 2016; 40:1159-1164. [PMID: 27876906 PMCID: PMC5118267 DOI: 10.1007/s12639-014-0641-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 12/22/2014] [Indexed: 10/24/2022] Open
Abstract
Leishmaniasis is a spectrum of disease condition with considerable health impacts, caused by different species of Leishmania. This disease is currently endemic in 98 countries and territories in the world. There are many treatment modalities for cutaneous leishmaniasis. The use of topical terbinafine in the treatment of cutaneous leishmaniasis has recently been considered. Eighty-eight participants more than two years old with proven acute CL by a positive direct smear were randomly allocated to one of the two study arms: first group received meglumine antimoniate (Glucantime) 20 mg/kg/day intramuscular injection (IM) plus a placebo ointment (Mahan Vaseline) for 20 days. The second group received meglumine antimoniate (Glucantime) 20 mg/kg/day IM plus topical terbinafine, for 20 days and were monitored closely by dermatologist during the course of the study. Crude regression analysis showed that there was no significant difference between placebo and intervention group regarding partial or complete treatment (partial treatment: HRcrude = 1.1, CI 95 % = 0.7-1.7; complete treatment: HRcrude = 1.1, CI 95 % = 0.8-1.7). Although, there was no statistically significant different between the two treatment groups, but clinically it seems that the treatment rate in those who receive glucantime plus terbinafine was more effective than the other group. However this rate depended on the type of lesions. As data indicated ulcerated nodules, papules and plaque in experimental group have been completely improved two times faster than placebo group. Ulcerated nodules, nodules and plaque were partially improved faster in those used tebinafine than placebo ointment.
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Affiliation(s)
- Saeedeh Farajzadeh
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Amireh Heshmatkhah
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Behrooz Vares
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Elham Mohebbi
- Research Center for Modeling in Health, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Azadeh Mohebbi
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahin Aflatoonian
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Sana Eybpoosh
- Regional Knowledge Hub and WHO Collaboration Center for HIV Surveillance, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Iraj Sharifi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Aflatoonian
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Ali Reza Fekri
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahshid Mostafavi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
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Farajzadeh S, Hakimi Parizi M, Haghdoost AA, Mohebbi A, Mohammadi S, Pardakhty A, Eybpoosh S, Heshmatkhah A, Vares B, Saryazdi S, Fekri AR, Mohebbi E. Comparison between intralesional injection of zinc sulfate 2 % solution and intralesional meglumine antimoniate in the treatment of acute old world dry type cutaneous leishmaniasis: a randomized double-blind clinical trial. J Parasit Dis 2014; 40:935-9. [PMID: 27605813 DOI: 10.1007/s12639-014-0609-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 11/01/2014] [Indexed: 10/24/2022] Open
Abstract
Zinc sulfate (ZS) has been used for the treatment of acute cutaneous leishmaniasis (CL) in both forms of in vivo and in vitro recently. The aim of the present study was to compare the efficacy of intralesional injection of ZS 2 % solution with intralesional glucantime in the treatment of acute CL. In this double-blind randomized clinical trial, 80 cases with acute old world dry type CL were enrolled in the study. The treatment protocol in the first group consisted of intralesional injection of ZS 2 % vials once a week for 10 weeks or sooner in case of complete resolution of the lesions. In the second group, intralesional glucantime once a week for 10 weeks or sooner in case of complete resolution of the lesions were used. In both groups cryotherapy was performed once every other week for 10 weeks. In ZS versus second group, partial and complete clinical response was observed with fewer injections although this difference was not statistically significant. In addition, we found that the trend of treatment in second group was faster but again it was not significant [partial treatment: hazard ratio (HR) 1.4, 95 % CI 0.7-2.9; complete treatment: HR 1.3, 95 % CI 0.6-2.8]. The results of this study showed that the intralesional injection of ZS 2 % solution was as effective as glucantime on the healing of the acute old world dry type CL.
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Affiliation(s)
- Saeedeh Farajzadeh
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Hakimi Parizi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Akbar Haghdoost
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Azadeh Mohebbi
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Saman Mohammadi
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Pardakhty
- Pharmaceutics Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sana Eybpoosh
- Research Center for Social Determinants of Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Amireh Heshmatkhah
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Behrooz Vares
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Simin Saryazdi
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Reza Fekri
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Elham Mohebbi
- Research Center for Modeling in Health, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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