TITLE:
Topical Therapy of Acute Cutaneous Leishmaniasis Using Zinc Sulphate Solution 25% versus Podophyllin Solution 25%
AUTHORS:
Khalifa E. Sharquie, Adil A. Noaimi, Zinah A. A. Sharara, Banaz A. Saleh, Wasnaa S. Al-Salam
KEYWORDS:
Cutaneous Leishmaniasis, Topical Zinc Sulphate, Topical Podophyllin, Sharquie’s Modified Leishmania Score
JOURNAL NAME:
Journal of Cosmetics, Dermatological Sciences and Applications,
Vol.7 No.3,
September
30,
2017
ABSTRACT: Background: Zinc sulphate as intralesional and oral therapy was
used as a successful therapy in treatment of cutaneous leishmaniasis while 25%
topical podophyllin is now commonly
used in the treatment of cutaneous leishmaniasis. Objective: To treat acute cutaneous leishmaniasis
using topical zinc sulphate solution 25% to be compared with topical podophyllin
solution 25%. Patients and Methods: This is a
single, blind, interventional, comparative study done in the Department of
Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq during the period from
January 2015 to June 2015. Forty patients with a total 88 lesions of acute cutaneous
leishmaniasis were enrolled in this study; 54 (61.36%) were dry lesions and 34 (38.6%) were ulcerative
type. The duration of lesions ranged from 2 - 11 (7.7 +
2.483) weeks. The size of the lesions ranged from 0.3 to 8 (2.13 ± 1.53) cm. There were 21 females and 19
males, female to male ratio (1.1:1) and their ages ranged from 1 to 60 (25.92 ± 16.59) years. Diagnosis was confirmed by tissue
smear and histopathology. Lesions were divided into two groups with matching
types and sizes, and scored according to Sharquie modified
Leishmania score to assess the objective response to the topical or systemic
therapy and then during follow up responses were graded into mild, moderate, marked response and
complete clearance. Group A treated with topical 25% podophyllin solution once
weekly for a maximum of 6 weeks, while group B was treated with topical 25%
zinc sulphate solution twice daily for 6 weeks. Follow up was every 2 weeks
during therapy, and once monthly for 3 months after therapy. Results: A total of 40 patients with
clinical diagnosis of acute cutaneous leishmaniasis were included in this
study, with a total of 88 lesions. Fifteen (37.50%) patients had single lesion
and 25 (62.50%)
patients had multiple lesions. Family history of CL was positive in 42.5% of
patients. At the end of six weeks after starting therapy, the total cure rate
in patients treated by topical podophyllin (both
marked and complete responses) was seen in 32 (82%) lesions, while the cure
rate in patients treated by topical zinc sulphate was in 36 (73.4%) lesions.
There was no statistical significant difference between the cure rates of both
groups. No important local or systemic side effects were seen in any patients. Conclusion: Topical zinc sulphate 25% is an effective simple
non-invasive non-costly safe topical therapy for cutaneous leishmaniasis and
without any contraindications for its use and free of side effects and was as
effective as topical podophyllin.