BACKGROUND: Cutaneous leishmaniasis (CL) is an endemic disease in Iran, particularly in Kerman Province. Leishmaniasis recidivans (LR) is one of the characteristics of this disease with a chronic course. Most patients with LR are resistant to the usual treatments. METHODS: Thirty-two patients (18 females and 14 males), suffering from LR, whose disease had been demonstrated by previous direct smears or skin biopsies, were included in this study in Kerman. The duration of disease in all patients was more than 1.5 years, and they had all previously received various drugs for their disease. All patients were treated with a combination of oral allopurinol (20 mg/kg for 30 days) and intramuscular injection of meglumine antimoniate (50 mg/kg for 15 days) and were followed up for 2 years. Skin biopsies were obtained from the skin lesions of nine cases at the beginning (baseline), during, and end of therapy. All patients were checked for complete blood count (CBC) and liver and kidney function tests on the first and last day of treatment. RESULTS: All patients, except two (87.5%), responded well to treatment within 30 days. No significant side-effects were observed. The disease of two patients (Cases 24 and 28) recurred 6 and 13 months after treatment, respectively. Histologic examination of nine cases during and at the end of therapy showed a progression to atrophied granulomata, more lymphocytic than histiocytic infiltration, and, finally, fibrosis replacing the granulomata. CONCLUSIONS: From the results of this study, a combination of allopurinol plus meglumine antimoniate may be considered as a highly effective treatment for LR.
BACKGROUND:Cutaneous leishmaniasis (CL) is an endemic disease in Iran, particularly in Kerman Province. Leishmaniasis recidivans (LR) is one of the characteristics of this disease with a chronic course. Most patients with LR are resistant to the usual treatments. METHODS: Thirty-two patients (18 females and 14 males), suffering from LR, whose disease had been demonstrated by previous direct smears or skin biopsies, were included in this study in Kerman. The duration of disease in all patients was more than 1.5 years, and they had all previously received various drugs for their disease. All patients were treated with a combination of oral allopurinol (20 mg/kg for 30 days) and intramuscular injection of meglumine antimoniate (50 mg/kg for 15 days) and were followed up for 2 years. Skin biopsies were obtained from the skin lesions of nine cases at the beginning (baseline), during, and end of therapy. All patients were checked for complete blood count (CBC) and liver and kidney function tests on the first and last day of treatment. RESULTS: All patients, except two (87.5%), responded well to treatment within 30 days. No significant side-effects were observed. The disease of two patients (Cases 24 and 28) recurred 6 and 13 months after treatment, respectively. Histologic examination of nine cases during and at the end of therapy showed a progression to atrophied granulomata, more lymphocytic than histiocytic infiltration, and, finally, fibrosis replacing the granulomata. CONCLUSIONS: From the results of this study, a combination of allopurinol plus meglumine antimoniate may be considered as a highly effective treatment for LR.
Authors: Iraj Sharifi; Mohammad Reza Aflatoonian; Ali Reza Fekri; Maryam Hakimi Parizi; Abbas Aghaei Afshar; Ahmad Khosravi; Fatemeh Sharifi; Behnaz Aflatoonian; Ali Khamesipour; Yahya Dowlati; Farrokh Modabber; Abolhasan Nadim Journal: Iran J Public Health Date: 2015-03 Impact factor: 1.429
Authors: Mohammad Reza Aflatoonian; Iraj Sharifi; Behnaz Aflatoonian; Mehdi Bamorovat; Amireh Heshmatkhah; Zahra Babaei; Pooya Ghasemi Nejad Almani; Mohammad Ali Mohammadi; Ehsan Salarkia; Abbas Aghaei Afshar; Hamid Sharifi; Fatemeh Sharifi; Ahmad Khosravi; Mehrdad Khatami; Nasir Arefinia; Alireza Fekri; Saeideh Farajzadeh; Ali Khamesipour; Mehdi Mohebali; Mohammad Mehdi Gouya; Mohammad Reza Shirzadi; Rajender S Varma Journal: PLoS Negl Trop Dis Date: 2019-06-12
Authors: I Sharifi; N Nakhaei; Mr Aflatoonian; M Hakimi Parizi; Ar Fekri; H Safizadeh; Mr Shirzadi; Mm Gooya; A Khamesipour; A Nadim Journal: Iran J Public Health Date: 2011-06-30 Impact factor: 1.429