Comparison Between Intralesional Meglumine Antimoniate and Combination of Trichloroacetic Acid 50% and Intralesional Meglumine Antimoniate in the Treatment of Acute Cutaneous Leishmaniasis: A Randomized Clinical Trial

Background: Cutaneous leishmaniasis (CL) is an endemic disease in Iran. Pentavalent antimonials including meglumine antimoniate (MA) are still the gold standard treatment. Trichloroacetic acid (TCA) is used in treatment of acne scar, photodamaged skin, and some other dermatologic diseases. Considering the TCA potential to induce collagen synthesis and its efficacy in the treatment of papular CL lesions, this study was conducted to assess the efficacy of combined intralesional MA and TCA in comparison to MA alone in treatment of CL

Objectives: This study was designed to compare the efficacy of the combination therapy of intralesional MA and TCA with intralesional MA alone in the treatment of CL

Patients and Methods: A total of 200 patients with confirmed CL were selected and randomized into two treatment groups. Both groups were treated with intralesional injection of MA twice a week until complete resolution of the lesions or end of the eighth week. In combination therapy group, TCA was applied to the lesions fortnightly for eight weeks. Data were analyzed statistically using chi-square, student t, and Kaplan-Meier tests

Results: Complete resolution of the lesions was achieved in 79.2% of patients treated with MA and 85.7% of patients receiving combination therapy (P > 0.05). There was a significant difference in time to achieve the complete resolution between the groups with an accelerated resolution rate in the combination therapy group (P < 0.05)

Conclusions: According to the results of this study, combination therapy with intralesional MA and TCA 50% could accelerated the resolution of CL lesions with no significant difference in complete resolution rate in comparison to the patients treated with intralesional MA alone. Topical application of TCA 50% as an adjuvant therapy might have some advantages in decreasinge the resolution time of the lesions in patients with CL

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