Journal of Kerman University of Medical Sciences

Evaluation of clinical risk factors for systemic antimony treatment failure in patients with acute cutaneous leishmaniasis referred to dermatology clinics of Mashhad University of Medical Sciences, Iran

Document Type : Original Article

Authors

Yalda Nahidi 1
Vahid Mashayekhi Goyonlo 1
Malihe Dadgarmoghaddam 2
Maesumeh Hosseininejad 3
Tahmineh Malakifard 1
Yasaman Rastgar 1

1 Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Community Medical Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 cutaneous leishmaniasis research center, Mashhad university of medical sciences, Mashhad, Iran

https://doi.org/10.34172/jkmu.2023.43
Abstract
Background: Systemic or topical form of pentavalent antimony compounds such as Meglumine Antimoniate (MA) are used as Standard treatment for cutaneous leishmaniasis (CL). However an increasing number of studies demonstrate evidence of treatment failure with said drugs. The objective of this study was to determine the factors associated with systemic MA treatment failure in patients with acute cutaneous leishmaniasis.
Methods: In this case-control study, patients with urban CL who were referred to leishmaniasis clinics in Mashhad from 2017 to 2018 were followed up 12 months after the start of treatment and were evaluated for improvement or failure according to the national leishmaniasis protocol.
Results: 112 cases of CL, 59 men and 53 women with a mean age of 23.3 ± 21.11 years were studied. The number of patients with clinical improvement was significantly higher in women (P = 0.005). Also age, BMI, occupation and education, the possible infection and living location, past medical, drug and leishmaniasis recurrence history, lesion’s characteristics, ulceration were also significantly different between the two groups of improved and unhealed patients.
Conclusion: The results of this study showed that the male sex, age less than 18 years, receiving pentostam, previous treatment history, lymphadenopathy, urban leishmaniasis, duration of illness more than 4 months, having a single lesion especially on the face, BMI less than 18 and a lesion size of more than 3 cm is more common in patients with treatment failure.

Highlights

Yalda Nahidi(google scholar)(pubmed)

Vahid Mashayekhi Goyonlo(google scholar)(pubmed)

Malihe Dadgarmoghaddam(google scholar)(pubmed)

Tahmineh Malakifard(google scholar)(pubmed)

(google scholar)(pubmed)

(google scholar)(pubmed)

(google scholar)(pubmed)

(google scholar)(pubmed)

(google scholar)(pubmed)

 

Keywords

Cutaneous leishmaniasis
antimony compounds
systemic treatment, treatment failure
Subjects
Journal of Kerman University of Medical Sciences
Volume 30, Issue 5
September and October 2023
Pages 253-260

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