Treatment of GlucantimTM - Resistant Cutaneous Leishmaniasis Using Combination Therapy of Allopurinol and Trichloroacetic Acid (TCA) 50%; Report of Three Cases

Background: There are 3 main forms of leishmaniasis-visceral, cutaneous, and mucocutaneous. Leishmania parasites are transmitted by the bite of infected female phlebotomine sand flies. Cutaneous leishmaniasis (CL) is the most common form of leishmaniasis and causes skin lesions, leaving life-long scars and serious disability. About 95% of CL cases occur in the Americas, the Mediterranean basin, the Middle East and Central Asia. Over two thirds of new CL cases occur in 6 countries that Iran (Islamic Republic of) is one of them. An estimated 0.6 million to 1 million new cases occur worldwide annually. If there is no remission with Glucantim as a choice of drug, other treatments such as cryotherapy and thermotherapy methods are used or other drugs such as allopurinol, pentamidine and amphotericin are prescribed in this disease. The use of trichloroacetic acid (TCA) 50% solution is another effective treatment. Case presentation: We report three cases (two women and one man) of cutaneous leishmaniasis resistant to Glucantim treated with combination therapy of allopurinol and TCA 50%. Conclusion: According to the results, the use of combination therapy of allopurinol and TCA 50% could be used as one of the alternative treatments in GlucantimTMresistant cutaneous leishmaniasis.