Cutaneous Leishmaniasis Due to L. braziliensis or L. peruviana: Systemic Treatment After Local Therapy Has Not Achieved Healing
Clinical Scenario
This protocol covers patients with cutaneous leishmaniasis caused by Leishmania braziliensis or Leishmania peruviana in whom an initial course of local treatment did not result in complete healing of the cutaneous lesion.
Prior Treatment — Insufficient Response
The preceding treatment line used local approaches: local infiltration with antimonials (with or without cryotherapy), topical paromomycin or methylbenzethonium chloride ointment, or thermotherapy. The target of that regimen was complete reepithelialization of the cutaneous lesion. Treatment failure is considered present when reepithelialization remains incomplete three months after starting therapy — and that threshold was not met.
Next Step — Partial Overview
Once local therapy has failed to achieve complete lesion healing, the protocol moves to systemic treatment. One class of agents with an established role in this setting is the pentavalent antimonials — but the full set of systemic options, the criteria governing which applies, and all regimen specifics are available only in the complete protocol below.
References
DOI: 10.1111/jtm.12089
- Treatment of L. braziliensis, Leishmania peruviana
- All other cases—systemic treatment:
- Treatment failure is present when reepithelialization is incomplete 3 months after starting therapy.
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