Comparison Between the Efficacy of Photodynamic Therapy and Topical Paromomycin in the Treatment of Old World Cutaneous Leishmaniasis: A Placebo-Controlled, Randomized Clinical Trial



Asilian A¹ ; Davami M^{2, 3} Show Affiliations
Source: Journal of Isfahan Medical School Published:2012

Abstract

Background: The optimal treatment for cutaneous leishmaniasis (CL) has not been established. Topical paromomycin is one of the many drugs that have been suggested for the treatment of CL caused by leishmania major. Recently, photodynamic therapy (PDT) has been reported to be effective in the treatment of CL. The aim of the present study was to compare the parasitological and clinical efficacy of PDT versus topical paromomycin in patients with old world CL caused by leishmania major in Iran. Methods: In this trial, 60 patients with the clinical and parasitological diagnosis of CL were recruited and were randomly divided in to three treatment groups of 20 subjects each. Group 1 was treated with weekly topical PDT, and groups 2 and 3 received twice-daily topical paromomycin and placebo, respectively. The duration of treatment was 4 weeks for all groups. These groups were followed for 2 months after termination of treatment. Findings: In total, 57 patients with 95 lesions completed the study. At the end of thestudy, complete improvement was seen in 29 out of 31 (93.5%), 14 out of 34 (41.2%) and 4 out of 30 lesions (13.3%) in groups 1, 2 and 3, respectively (P < 0.001). At the same timepoint, 100%, 64.7%, and 20% of the lesions had parasitological cure in groups 1, 2 and 3, respectively (P < 0.001). Conclusion: Topical PDT can be used safely as a rapid and highly effective alternative treatment choice for old world CL in selected patients. © 2012, Isfahan University of Medical Sciences(IUMS). All rights reserved.