Comparisso of intralesionally injected Zink sulfate and pentavalent Antimony compound in treatment of acute cutaneous leishmaniasis

Abstract

acute cutaneous leishmaniasis(ACL) is an endemic disease in developing countries.the first line drug for treatment of ACL.according to WHO recommendation,is the pentavalent antimony compounds such as meglumine antimoniate(Glucantime{SB}).high cost ,side effects,multiple injections and incomplete efficacy are limitations of this therapy.we evaluated the efficacy of intralesional(IL) injection of zink sulfate 2% in treatment of ACL and compared that with efficacy of IL injection of glucantime(sb).this prospective double-blind case control clinical trial was performed on 104 patients with typical lesions of ACL and positive direct smear.these patients were treated by IL injection of contents of one of two similar vials A or B.the vials were coded by an independent physician.the pateints were seen in two weeks intervals and injection was repeated when reqiered.improvement was evaluated by clinical examination and direct smear.follow-up period was six weeks.66 patients were followed until 6 weeks(35 patients from A group and 31 from B group). after 6 weeks,the cure rates were 60% for A solution and 83.87 % for B solution.after 2,4 and 6 weeks of treatment ,the responses to therapy with A solution were respectively 3.5+_1.14,3.68+_1.11 and 3.8+_1.05 versus 3.84+_1.11,4.6+_1.25,3.85+_1.24 for B solution.after second and forth weeks,the efficacy of treatment with B solution was higher than A solution (p<0.01),but after six weeks no significant differences were observed between two groups (p>0.05).after only one injection of B solution,cure rate was 54.84% reinjection significantly increased efficacy of A,but not of the B solution,Asolution was Glucantime and B solution was zink sulfat 2%.on the basis of this trial,treatment of ACL by intralesional injection of zink sulfate 2% may be effective.