TITLE:
Treatment of Acute Cutaneous Leishmaniasis by Oral Zinc Sulfate and Oral Ketocanazole Singly and in Combination
AUTHORS:
Khalifa E. Sharquie, Adil A. Noaimi, Wasnaa S. Al-Salam
KEYWORDS:
Cutaneous Leishmaniasis, Ketoconazole, Zinc Sulfate, Sharquie’s Modified Leishmania Score
JOURNAL NAME:
Journal of Cosmetics, Dermatological Sciences and Applications,
Vol.6 No.3,
June
6,
2016
ABSTRACT: Background: Cutaneous Leishmaniasis (CL) is an endemic disease in many countries
and caused by different species of Leishmania parasite. It results in a
deformed scar after a relatively long period. Many therapies have been tried in
treatment of this disease. Objective: To
compare the effect of oral zinc sulfate and oral ketoconazole singly and in
combination in the treatment of acute cutaneous leishmaniasis. Patients and Methods: This single,
blinded, therapeutic, controlled study was conducted in the Department of
Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq, during the period,
January 2015 to July 2015. Seventy-five patients with acute CL were enrolled in
this study. The total numbers of lesions were 327, and the duration of lesions
ranged from 4 to 12 (6.9 ± 0.7) weeks. The diagnosis was confirmed by smear and
histopathology. Patients were divided into three groups: 24 patients in Group A were treated with oral zinc
sulfate capsules 10 mg/kg/day for 6 weeks; 24 patients in Group B were treated with
ketoconazole tablets 200 mg twice daily for 6 weeks and 27 patients in Group C were treated orally with a
combination of zinc sulfate and ketoconazole for 6 weeks. All patients were
seen regularly every 2 weeks for 6 weeks of treatment period, then monthly for
the next three months as follow up period. Healing of the lesions was assessed
by using Sharquie’s modified Leishmania score to assess the objective response
to the topical or systemic therapy. Results：After six weeks, 75 patients have completed the
treatment, 24patients received zinc sulfate capsule, 24 patients received oral
ketoconazole and 27 patients received a combination of both treatments. The
cure rate was (60%) in the group receiving oral zinc sulfate capsuleand (50%)
in the one receiving oral ketoconazole tablet (P = 0.146) and (96%) in the combination group (P ? 0.04). Conclusion: The
combination therapy using oral zinc sulfate and oral ketoconazole gave a high
cure rate. The combination therapy is a new mode of therapy as both drugs act
in a synergistic way.