Instituto Nacional de Diagnostico y Referencia Epidemiologica, Colonia Santo Tomas, Secretaria de Salud del Estado de Tabasco e Hospital General de Comalcalco, Mexico DF; Gettysburg, Pennsylvania, Mexico
In Mexico cutaneous leishmaniasis (CL) occurs in 17 of 32 States, and is a serious public health problem. This is a report of treatment of CL patients in the State of Tabasco, Mexico with a localized current field-radio frequency (LCF-RF) device to generate precisely controlled heat as an alternative to prohibitively expensive drug treatment. It was not a controlled clinical trial, but rather an evaluation of the feasibility of this form of treatment for all CL patients encountered in the endemic area. A total of 201 previously diagnosed patients with CL caused by Leishmania mexicana were treated with a portable Thermosurgery™ LCF-RF generator powered by rechargeable batteries. The ages of the patients ranged from two to 75 years; the sex distribution was 63% males and 37% females. A single device was used in five different municipalities. Lesions were first anesthetized with 1% lidocaine HCl and moistened with normal saline solution. Treatment consisted of a single application that produced 50°C for 30 sec. After four weeks, 122 patients were available for evaluation, of which 95% were totally cured; (even those involving ear cartilage, which respond poorly to antimonials). At eight weeks post-treatment, 191 patients were evaluated, with a total cure rate of 90%. This form of treatment proved to be effective and convenient for use in primary health care facilities in Mexico and has many advantages over traditional forms of therapy.