A comparison between the efficacy of intralesional injection of 2% zinc sulfate solution with glucantime in the treatment of acute old world cutaneous leishmaniasis: a randomized, doubleblind, controlled clinical trial

Background: Several treatment modalities have been used for cutaneous leishmaniasis (CL) with various results. In vitro and in vivo studies have shown inhibitory effects of zinc sulfate (ZnS04) on Leishmania parasites. Objective: To compare the efficacy of intralesional injections of 2% ZnS04 solution with meglumine antimonate (Glucantime) in the treatment of acute Old World CL

Patients & Methods: Seventy-two patients with CL with a duration of less than 8 weeks were recruited in a randomized, double-blind, clinical trial in Isfahan province-an area endemic for Leishmania major-after giving written informed consent. They were treated with 6 weekly intralesional injections of either 2% sterile ZnSO4 solutions or Glucantime prepared in identical vials. The primary outcome measure was complete re-epithelialization of CL lesions

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Results: Among 36 patients with 53 lesions treated with ZnS04 and 36 patients with 53 lesions treated with Glucantime, 13patients with 19 lesions and 22 patients with 31 lesions completed the trial, respectively. Inadequacy of treatment was the main reason for drop-out in 12 (33.3%) and 2 (5.5%) patients in ZnS04 and Glucantime groups, respectively (P<0.05). Complete re-epithelialization was observed in 2 (10.5%) and 19(61.3%) lesions 1 week after the end of treatment in the ZnS04 and Glucantime groups, respectively (P<0.05)

Conclusion: A six-week course of weekly intralesional injections of 2% ZnSO4 solution was less effective than Glucantime in the treatment of acute Old World CL

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