Treatment of Cutaneous Leishmaniasis with Allopurinol Plus Itraconazole in Iran

Vahid Mashayekhi Goyonlo Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Search for other papers by Vahid Mashayekhi Goyonlo in
Current site
Google Scholar
PubMed
Close
,
Zahra Derakhshan Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Search for other papers by Zahra Derakhshan in
Current site
Google Scholar
PubMed
Close
, and
Emadodin Darchini-Maragheh Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Search for other papers by Emadodin Darchini-Maragheh in
Current site
Google Scholar
PubMed
Close
Restricted access

ABSTRACT.

Cutaneous leishmaniasis (CL) is a serious tropical disease and a neglected health challenge in Iran. Although limited data are available regarding anthroponotic CL, cases resistant to meglumine antimoniate (Glucantime) are increasingly being reported. Via an open-label noncontrolled case series, allopurinol (10 mg/kg/day) plus itraconazole (3–4 mg/kg/day) were orally administered for 1 month to 27 patients (56 lesions) with anthroponotic CL, most of whom were resistant to Glucantime. A mean lesion size of 3.5 ± 1.9 cm at baseline was reduced to 0.6 ± 1.0 after 1 month of treatment. Excellent treatment response was observed in 85.7% of lesions after 1 month. Recurrence only occurred in one patient in the 3-month follow-up session. This study presents preliminary evidence that oral allopurinol plus itraconazole could be an effective treatment in patients with anthroponotic CL.

Author Notes

Address correspondence to Emadodin Darchini-Maragheh, Dermatology Department, Emam-Reza Hospital, Emam-Reza Square, Mashhad 9137913316, Iran. E-mail: Emadoddin.darchini@yahoo.com; darchinime971@mums.ac.ir

Financial support: The study was supported by the Vice Chancellor for Research, Mashhad University of Medical Sciences, Mashhad, Iran.

Authors’ addresses: Vahid Mashayekhi Goyonlo, Zahra Derakhshan, and Emadodin Darchini-Maragheh, Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran, E-mails: mashayekhiv@mums.ac.ir, taraderakhshan93@gmail.com, and darchinime971@mums.ac.ir.

  • 1.

    Tayyebi M , Darchini-Maragheh E , Layegh P , Kiafar B , Goyonlo VM , 2021. The effect of oral miltefosine in treatment of antimoniate resistant anthroponotic cutaneous leishmaniasis: an uncontrolled clinical trial. PLoS Negl Trop Dis 15: e0009241.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Martinez S , Marr JJ , 1992. Allopurinol in the treatment of American cutaneous leishmaniasis. N Engl J Med 326: 741744.

  • 3.

    Husein‐ElAhmed H , Gieler U , Steinhoff M , 2020. Evidence supporting the enhanced efficacy of pentavalent antimonials with adjuvant therapy for cutaneous leishmaniasis: a systematic review and meta‐analysis. J Eur Acad Dermatol Venereol 34: 22162228.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Esfandiarpour I , Alavi A , 2002. Evaluating the efficacy of allopurinol and meglumine antimoniate (Glucantime) in the treatment of cutaneous leishmaniasis. Int J Dermatol 41: 521524.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Momeni AZ , Reiszadae MR , Aminjavaheri M , 2002. Treatment of cutaneous leishmaniasis with a combination of allopurinol and low‐dose meglumine antimoniate. Int J Dermatol 41: 441443.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Pinart M , Rueda JR , Romero GA , Pinzón-Flórez CE , Osorio-Arango K , Silveira Maia-Elkhoury AN , Reveiz L , Elias VM , Tweed JA , 2020. Interventions for American cutaneous and mucocutaneous leishmaniasis. Cochrane Database Syst Rev 8: CD004834.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Momeni AZ , Jalayer T , Emamjomeh M , Bashardost N , Ghassemi R , Meghdadi M , Javadi A , Aminjavaheri M , 1996. Treatment of cutaneous leishmaniasis with itraconazole. Randomized double-blind study. Arch Dermatol 132: 784786.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Yaich S , Charfeddine K , Masmoudi A , Masmoudi M , Zaghdhane S , Turki H , Hachicha J , 2013. Atypical presentation of cutaneous leishmaniasis in a renal transplant recipient successfully treated with allopurinol and fluconazole. Ann Saudi Med 33: 187191.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 1849 1434 197
Full Text Views 1198 167 0
PDF Downloads 209 22 0
 
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save