This protocol addresses the management of cutaneous leishmaniasis occurring during pregnancy. Pregnancy fundamentally changes which treatments can be considered safe, requiring a modified approach that protects the patient while accounting for fetal safety.
None of the available systemic treatments for cutaneous leishmaniasis are known to be safe in pregnancy. This means the standard systemic options must be withheld until after delivery, and management before that point is restricted to local and topical interventions.
The preferred approach relies on wound care and physical methods; topical treatment may also play a role. The full protocol specifies which physical interventions apply, under what conditions, and what the complete management pathway looks like — including what happens after delivery.
DOI: 10.1111/jtm.12089
Simple wound care or physical methods like cryotherapy, thermotherapy, or CO2 laser are preferred, despite the low level of evidence for efficacy.
As none of the systemic treatments are known to be safe during pregnancy, systemic treatment should be withheld until after delivery; topical treatment may be applied before.
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