Cutaneous Leishmaniasis Caused by L. tropica, L. infantum/donovani, or L. aethiopica — When Local Treatment Has Not Achieved Healing
This protocol targets cutaneous leishmaniasis caused by Leishmania tropica, Leishmania infantum/donovani, or Leishmania aethiopica in patients where initial local therapy has not produced complete healing of the cutaneous lesion.
Local treatment — including local infiltration with antimonials (with or without cryotherapy), topical ointment-based therapy, or local heat therapy — is appropriate for limited presentations. This protocol is triggered when that local approach has failed to achieve complete reepithelialization of the cutaneous lesion. Treatment failure is defined as incomplete reepithelialization 3 months after starting therapy.
After local treatment failure, systemic antileishmanial therapy is indicated. The protocol defines specific criteria — relating to lesion count, lesion size, anatomical location, and prior treatment response — that guide selection among available systemic options. The full treatment algorithm, agent selection, and criteria are detailed in the structured protocol.
Complete reepithelialization (healing) of the cutaneous lesion.
DOI: 10.1111/jtm.12089
- Treatment of L. tropica, Leishmania infantum/donovani, and Leishmania aethiopica
- More than three lesions, diameter >30 mm, delicate location, and/or refractory to local treatment
- Treatment failure is present when reepithelialization is incomplete 3 months after starting therapy.