Successful treatment of non-healing cases of cutaneous leishmaniasis, using a combination of meglumine antimoniate plus allopurinol.

Cutaneous leishmaniasis (CL) is endemic in many countries. It has been recognized as a major public health problem in Iran. The pentavalent antimonials are the first line drugs for the treatment of CL. Recently strains resistant to these drugs have been reported. Allopurinol (AL) has also been suggested for treatment of CL. The efficacy of combination of AL and meglumine antimoniate (MA) in treatment of non-healing cases of CL was evaluated. Non-healing cases of CL have been treated with combination of AL (20 mg/kg for 30 days) and meglumine antimoniate (60 mg/kg per day for 20 days). Twenty-six patients with lupoid leishmaniasis, 6 patients with chronic leishmaniasis and 5 patients who had unhealed leishmaniasis due to leishmanization were accepted for the study. All of the patients except two responded well to treatment, no side effects have been observed and a two year follow up showed no recurrence. A combination of AL and MA increase the antileishmanial effects of antimoniate. We suggest this combination therapy for non-healing and resistant cases of CL.