The Evaluation of Intralesional Glucantime and Cryotherapy plus Intralesional Glucantime Therapeutic Efficacy on Zoonotic Cutaneous Leishmaniasis: A Randomized Clinical Trial

Background: Currently, Glucantime is considered the first-line treatment of cutaneous Leishmaniasis. This study aimed to evaluation of intralesional Glucantime (IG) and Cryotherapy (Cryo) plus intralesional Glucantime (Cryo and IG) therapeutic efficacy on Zoonotic Cutaneous Leishmaniasis in Qom province, Iran. Materials and Methods: In this randomized controlled trial of 197 CL patients reported from Qom health centers, Iran during (2014-2017), 112 cases were entered to this study. According to the Iranian Ministry of Health therapeutic guide line of CL, 54 cases with 116 lesions received IG weekly, and 58 patients with 115 lesions received the IG once a week coupled with Cryo using liquid nitrogen once every two weeks. The average volume of injected solution per lesion was 0.2 ml to 0.5 ml into the border of the healthy skin and the onset of erythema in the lesions using insulin syringe needles. In second therapeutic method; cryotherapy with liquid nitrogen was performed by dipstick technique. At first, the lesion size and induration of lesions were recorded. After 7 and 12 weeks of treatment, lesions healing rate was monitored. Healing was defined as complete re-epithelialization and disappearance of induration. Results: Out of 112 CL patients, 54 cases with 116 lesions received IG, and 58 patients with 115 lesions received Cryo and IG. At 7th week after the initiation of treatment, complete healing was observed in 56 out of 116 lesions (48.1%) in the group which received weekly IG and 83 out of 115 lesions (72.2%) in the group which received biweekly Cryo plus IG. At 12th week after the treatment, the cure rate was 91% and 100% in group which received weekly IG and group which received IG once a week coupled with cryotherapy (p=0.001). Conclusion: Based on the findings, IG once a week coupled with cryotherapy was more effective compared with weekly IG and reduced the period of treatment.