Effective treatment with photodynamic therapy of cutaneous leishmaniasis: A case report (original) (raw)
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Efficacy of photodynamic therapy in the treatment of cutaneous leishmaniasis
The professional medical journal, 2019
… A limited number of case reports have studies the efficacy of Photodynamic Therapy (PDT) in management of Cutaneous Leishmaniasis (CL). Topical PDT is an innovative mode of therapy that works on principle of selective uptake of photosensitizing agent by CL lesions. Current study was conducted to determine efficacy of topical photodynamic therapy of CL. Study Design: Descriptive cross sectional study. Setting: Dermatology outdoor clinic PIMS Islamabad. Period: July 2015 to Jan 2016. Materials and Methods: Total 75 patients (>12 years) of either gender with biopsy proven CL lesions were included after ethical approval. Pregnant or lactating women, those with sensitivity to light or photo sensitizer were excluded. The selected cases were administered once a week sessions of topical 5-ALA PDT therapy. This therapy was continued till 4 weeks and efficacy was observed at 6 th week; efficacy labeled as yes if there was no erythema with resolution of papules, plaques or nodules, surrounded by normal healthy skin clinically and the histo-pathological smears revealing absence of amastigotes, otherwise labeled as non-effective. Results: Mean age was 24.37+7.43 years. There were 44(58.67%) females and 31(41.33%) males. Mean duration of disease was 40.29+11.73 days and mean size of lesion was 19.69+9.88 mm. Effective PDT outcome was seen in 67(89.33%) patients at 6 th week of therapy. Conclusion: This study concluded that topical photodynamic therapy is an effective method for treatment of Cutaneous Leishmaniasis.
Journal of lasers in medical sciences, 2015
Introduction American cutaneous leishmaniasis (ACL) occurs in the Americas from southern United States to northern Argentina. ACL has clinical importance due to the high incidence and severe clinical manifestations. 1 ACL can have 2 forms, the skin (the most frequent form of the disease with skin lesion) and mucocutaneous (partial or total destruction of mucous membranes surrounding the nasopharynx region). 1-3 There may also be disseminated disease with various skin ulcers, and the diffuse disease characterized by nodular lesions without the presence of ulceration. 2 ACL has been treated with pentavalent antimonials (N-methylglucamine), as the preferential drug, and polienics antibiotics (amphotericin B), aminoglicosideos (paromomycin) and antiprotozoal agent (pentamidine isothionate), 4 but they can lead to serious side effects and discontinuation of treatment by the patients. In recent years, alternative treatments have been used for ACL and among them, photodynamic therapy (PDT) has shown promising results. 4,5 PDT builds on the application of a photosensitizer compound into the target tissue that is illuminated with light
Experimental Parasitology, 2011
The aim of this study was to investigate the effectiveness of Photodynamic Therapy (PDT) using Methylene Blue (MB) as the photosensitizing compound and a Light-Emitting Diode (LED) in American cutaneous leishmaniasis (ACL). Hamsters were experimentally infected with Leishmania (Leishmania) amazonensis. After the development of the lesions in the footpad, the animals were treated with MB three times a week for 3 months. Ten minutes after each application of MB, the lesions were irradiated with LED for 1 h. The lesions were evaluated weekly by the measurement of the hamster footpad thickness. At the end of the treatment the parasitic load was quantified in the regional lymph node of the hamsters. The treatment promoted a decrease in the thickness of infected footpad (P = 0.0001) and reduction in the parasitic load in the regional lymph node (P = 0.0007) of the animals from group treated with MB + LED. PDT using MB + LED in ACL caused by L. amazonensis shows a strong photodynamic effect. This therapy is very promising, once it is an inexpensive system and the own patient can apply it in their wound and in their house without the need of technical assistance.
Antimicrobial Agents and Chemotherapy, 2015
An evaluation of the leishmanicidal activityin vitroandin vivoof hypericin, an expanded-spectrum photosensitizer found inHypericum perforatum, is presented. Hypericin was evaluated against intracellular amastigotesin vitroofLeishmania(Viannia)panamensis. A topical formulation containing 0.5% hypericin was developed and assayedin vivoin a hamster model of cutaneous leishmaniasis. Results demonstrate that hypericin induces a significant antiamastigote effectin vitroagainstL. panamensisby decreasing the number of parasites inside infected cells. The topical formulation of 0.5% hypericin allows healing ofL. panamensis-induced lesions upon a topical application of 40 mg/day plus visible-light irradiation (5 J/cm2, 15 min), twice a week for 3 weeks.
Toward an approach for cutaneous leishmania treatment
Our Dermatol Online, 2013
Introduction: Most drugs being used for cutaneous leishmania treatment are still non well effective, extremely expensive, risky with side effects, more invasive and relapses still occur. The purpose of the study is to achieve more understanding of cutaneous leishmania disease and through that to try an other form of treating substance that can provide better results with less damages to the tissues. Methods: Seven patients infected with cutaneous leishmania were chosen for DAB-1 application. Clinical as well as microscopic study and follow-up with documenting photos for the lesions, indicating the starting point for the cases before treatment initiation, and the disease development after DAB-1 application was accomplished. Results: Before treatment, the lesions size was between 1.8-7 cm. Cases were inflamed and ulcerated. After 8 days of treatment, inflammation shrank. After 16 days, the lesions and the ulcers decreased into almost half their size. 24 days post treatment, inflammation began disappearing and epithelial islands continued to grow inside the ulcers filling a considerable part of them. By the end of day 32, ulcers were covered with a continuous layer of epithelium, and heal is achieved after two to three months of treatment. Conclusion: The study proved that DAB-1 is capable of healing leishmania in 6-8 weeks after application and is compared favorably to the other traditionally used drugs. DAB-1 could be a breakthrough in cutaneous leishmania treatment.