Cutaneous Leishmaniasis Caused by Leishmania major — Management After Local Treatment Has Not Achieved Healing

Clinical Scenario

This protocol is for patients with cutaneous leishmaniasis caused by Leishmania major in whom an initial course of local treatment did not result in complete healing of the cutaneous lesion.

Previous Treatment — Goal Not Reached

The preceding step used local therapy — options included flash cryotherapy combined with local infiltration with antimonials, topical paromomycin- or methylbenzethonium chloride-based ointment, or local heat therapy. When complete reepithelialization of the lesion is not achieved with these local measures, management is escalated to the present protocol.

Treatment Goal

Complete reepithelialization — full healing — of the cutaneous lesion. Incomplete reepithelialization at three months after starting therapy constitutes treatment failure.

Approach (Partial Overview)

For lesions that are extensive, situated in delicate anatomical locations, or refractory to local measures, the protocol moves to systemic treatment. The full protocol specifies the distinct systemic options available and the criteria that inform the choice among them — details are accessible via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/jtm.12089

Treatment of L. major

More than three lesions, diameter >30 mm, delicate location, and/or refractory to local treatment.

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