Journal of Isfahan Medical School

Journal of Isfahan Medical School

Effectiveness of 0.4% Amphotericin gel along with the intralesional injection of Glucantime compared with intralesional injection of Glucantime alone for acute cutaneous leishmaniasis treatment

Document Type : Original Article(s)

Authors
1 Assistant Professor of Dermatology, Skin Diseases and Leishmaniasis Research Center, Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associate Professor of Dermatology, Skin Diseases and Leishmaniasis Research Center, Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran
3 MD, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
4 MD, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
5 MSc of Epidemiology, Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
10.48305/jims.v44.i866.0974
Abstract
Background: The aim of the present study was to investigate the effectiveness of topical amphotericin gel on leishmaniasis cutaneous lesions by adding this drug to the standard treatment of leishmaniasis.
Methods: This randomized clinical trial was conducted on two groups of patients. The first group was treated with weekly intralesional injections of glucantime alone. The second group was treated weekly with intralesional injections of glucantime and 0.4% amphotericin topical gel daily.
Findings: The mean (standard deviation) age of 32 participants in the study was 33.4 (14.8) and 29 (72.5%) of them were men. 70% of patients in the glucantime alone group and 80% of patients in the amphotericin group showed complete cure. There was no significant difference between the two groups in terms of the outcome by examining changes in size and induration of the lesions (P>0.05). Results of repeated measures revealed that the effect of the course was significant for the change in the size of the lesions in the two drug groups (P=0.36).
Conclusion: The combination of amphotericin gel with the standard treatment of cutaneous leishmaniasis causes a slight increase in the effectiveness of the treatment, although this slight improvement was not significant in our study.

Highlights

Nazila Poostiyan: Google Scholar, PubMed

Zabihollah Shahmoradi: Google Scholar

Setayesh Sindarreh: Google Scholar, PubMed

Keywords
Subjects

1.     Taslimi Y, Zahedifard F, Rafati S. Leishmaniasis and various immunotherapeutic approaches. Parasitology 2018; 145(4): 497-507.
2.     Sosa N, Pascale JM, Jiménez AI, Norwood JA, Kreishman-Detrick M, Weina PJ, et al. Topical paromomycin for New World cutaneous leishmaniasis. PLoS Negl Trop Dis 2019; 13(5): e0007253.
3.     Burza S, Croft SL, Boelaert M. Leishmaniasis. Lancet. 2018; 392(10151): 951-70.
4.     Leishmaniasis: World Health Organization; 2022. Available from: https://www.who.int/en/news-room/fact-sheets/detail/leishmaniasis.
5.     Razavi MR, Shirzadi MR, Mohebali M, Yaghoobi-Ershadi MR, Vatandoost H, Shirzadi M, et al. Human Cutaneous Leishmaniosis in Iran, Up to Date-2019. J Arthropod Borne Dis 2021; 15(2): 143-51.
6.     Bennis I, Thys S, Filali H, De Brouwere V, Sahibi H, Boelaert M. Psychosocial impact of scars due to cutaneous leishmaniasis on high school students in Errachidia province, Morocco. Infect Dis Poverty 2017; 6(1): 46.
7.     World Health Organization. Report of a meeting of the WHO Expert Committee on the Control of Leishmaniases, Geneva, Switzerland; 2010.
8.     Steverding D. The history of leishmaniasis. Parasit Vectors 2017; 10(1): 82.
9.     Eskandari SE, Firooz A, Nassiri-Kashani M, Jaafari MR, Javadi A, Miramin-Mohammadi A, et al. Safety evaluation of nano-liposomal formulation of amphotericin B (sina ampholeish) in animal model as a candidate for treatment of cutaneous leishmaniasis. J Arthropod Borne Dis 2018; 12(3): 269-75.
10.  Akbari M, Oryan A, Hatam G. Immunotherapy in treatment of leishmaniasis. Immunol Lett 2021; 233: 80-6.
11.  Masmoudi A, Maalej N, Mseddi M, Souissi A, Turki H, Boudaya S, et al. Glucantime injection: benefit versus toxicity. Med Mal Infect 2005; 35(1): 42-5.
12.  Saha AK, Mukherjee T, Bhaduri A. Mechanism of action of amphotericin B on Leishmania donovani promastigotes. Mol Biochem Parasitol 1986; 19(3): 195-200.
13.  Ono M, Takahashi K, Taira K, Uezato H, Takamura S, Izaki S. Cutaneous leishmaniasis in a Japanese returnee from West Africa successfully treated with liposomal amphotericin B. J Dermatol 2011; 38(11): 1062-5.
14.  Layegh P, Rajabi O, Jafari MR, Emamgholi Tabar Malekshah P, Moghiman T, Ashraf H, et al. Efficacy of topical liposomal amphotericin B versus intralesional meglumine antimoniate (Glucantime) in the treatment of cutaneous leishmaniasis. J Parasitol Res 2011; 5(20): 56-65.
15.  Eskandari SE, Firooz A, Nassiri-Kashani M, Jaafari MR, Javadi A, Mohammadi AM, et al. Safety evaluation of topical application of nano-liposomal form of amphotericin B (SinaAmpholeish) on healthy volunteers: phase I clinical trial. Iranian J Parasitol 2019; 14(2): 190-7.
16.  Khamesipour A, Mohammadi A, Jaafari M, Eskandari S, Tasbihi M, Javadi A, et al. Pilot study of safety and efficacy of topical liposomal amphotericin B for cutaneous leishmaniasis caused by Leishmania major in Islamic Republic of Iran. East Mediterr Health J 2022; 28(9): 658-63.
17.  Karamian M, Bojd MF, Salehabadi A, Hemmati M, Barati D. Effectiveness of meglumine antimoniate against L. tropicain a recently emerged focus of cutaneous leishmaniasis in Birjand, eastern Islamic Republic of Iran. East Mediterr Health J 2015; 21(4): 280-6.
18.  Shamsi Meymandi S, Zandi S, Aghaie H, Heshmatkhah A. Efficacy of CO2 laser for treatment of anthroponotic cutaneous leishmaniasis, compared with combination of cryotherapy and intralesional meglumine antimoniate. J Eur Acad Dermatol Venereol 2011; 25(5): 587-91.
19.  Alam E, Abbas O, Moukarbel R, Khalifeh I. Cutaneous leishmaniasis: an overlooked etiology of midfacial destructive lesions. PLoS Negl Trop Dis 2016; 10(2): e0004426.
20.  Farajzadeh S, Hakimi Parizi M, Haghdoost AA, Mohebbi A, Mohammadi S, Pardakhty A, et al. Comparison between intralesional injection of zinc sulfate 2% solution and intralesional meglumine antimoniate in the treatment of acute old world dry type cutaneous leishmaniasis: a randomized double-blind clinical trial. J Parasit Dis 2016; 40(3): 935-9.
Volume 44, Issue 866
2nd Week, August
July and August 2026
Pages 974-982

  • Receive Date 18 March 2025
  • Accept Date 21 January 2026