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Old World Cutaneous Leishmaniasis in Iran: Clinical Variants and Treatments Publisher Pubmed



Firooz A1 ; Mortazavi H2 ; Khamesipour A1 ; Ghiasi M2 ; Abedini R2 ; Balighi K2 ; Esmaili N2 ; Nassirikashani M1 ; Eskandari SE1 ; Mohebali M3 ; Mir Amin Mohammadi A1 ; Dowlati Y1
Authors
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Authors Affiliations
  1. 1. Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Dermatology, Tehran University of Medical Sciences, Razi Hospital, Tehran, Iran
  3. 3. Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Dermatological Treatment Published:2021


Abstract

Background: Old World cutaneous leishmaniasis (OWCL) is endemic in Iran and most cases of cutaneous leishmaniasis (CL) are caused by Leishmania major, and then Leishmania tropica, and rarely by Leishmania infantum. Objective: We aimed to describe clinical variants of OWCL and their treatments. Method: Through literature search in PubMed, Scopus and Embase and google scholar, we have found articles about variant clinical pictures of OWCL and their treatments. Results: The following clinical variants of OWCL namely; localized forms, zosteriform, erysipeloid, eczematoid, warty, localized Leishmania lymphadenitis, sporotrichoid, hyperkeratotic, impetiginized, mucosal involvement in CL, lupoid leishmaniasis, chronic lesions due to leishmanization, disseminated cutaneous leishmaniasis, reactivation of CL after transplantation and coexistence of CL with other diseases, are reported from Iran. The mainstay of therapy remains pentavalent antimonial compounds and cryotherapy is an adjuvant to therapy. Treatment with antifungal agents, miltefosine, amphotericin B and herbal extract such as ZH-E have also been used. Treatment of CL in chronic cases and in immunosuppressed patients is difficult and relapse may occur. Conclusion: In clinical variants of CL with long duration and multiple lesions, systemic pentavalent antimonial compounds are first step of therapy. In case of incomplete response or resistant to classic treatment, combination therapy is indicated. © 2020 Taylor & Francis Group, LLC.
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