Treatment of cutaneous leishmaniasis by photodynamic therapy.

BACKGROUND

Cutaneous leishmaniasis represents a common health problem and standard treatments are often ineffective or yield poor cosmetic results.

OBJECTIVE

We compared the efficacy of photodynamic therapy (PDT) with paromomycin sulfate in 10 lesions of cutaneous leishmaniasis.

METHODS

Five lesions were treated by PDT with Metvix (Photocure, Oslo, Norway) and 75 J/cm(2) red light. PDT was performed twice weekly and, after 12 weeks, once weekly. The other 5 lesions were treated with paromomycin sulfate once daily. All nonresponding lesions of the paromomycin-treated plaques finally also underwent PDT.

RESULTS

All 5 lesions treated by PDT and 2 of the paromomycin sulfate-treated plaques were clinically and histologically Leishmania free. Three lesions with poor response to paromomycin sulfate finally responded to subsequent PDT. Ten months after therapy there was no recurrence, and cosmetic outcome after PDT was excellent.

CONCLUSION

PDT may be an effective therapeutic alternative in cutaneous leishmaniasis.