Evaluation of clinical risk factors for systemic antimony treatment failure in patients with acute cutaneous leishmaniasis referred to dermatology clinics of Mashhad University of Medical Sciences, Iran

Background: Systemic or topical form of pentavalent antimony compounds such as Meglumine Antimoniate (MA) are used as Standard treatment for cutaneous leishmaniasis (CL). However an increasing number of studies demonstrate evidence of treatment failure with said drugs. The objective of this study was to determine the factors associated with systemic MA treatment failure in patients with acute cutaneous leishmaniasis. Methods: In this case-control study, patients with urban CL who were referred to leishmaniasis clinics in Mashhad from ۲۰۱۷ to ۲۰۱۸ were followed up ۱۲ months after the start of treatment and were evaluated for improvement or failure according to the national leishmaniasis protocol. Results: ۱۱۲ cases of CL, ۵۹ men and ۵۳ women with a mean age of ۲۳.۳ ± ۲۱.۱۱ years were studied. The number of patients with clinical improvement was significantly higher in women (P = ۰.۰۰۵). Also age, BMI, occupation and education, the possible infection and living location, past medical, drug and leishmaniasis recurrence history, lesion’s characteristics, ulceration were also significantly different between the two groups of improved and unhealed patients. Conclusion: The results of this study showed that the male sex, age less than ۱۸ years, receiving pentostam, previous treatment history, lymphadenopathy, urban leishmaniasis, duration of illness more than ۴ months, having a single lesion especially on the face, BMI less than ۱۸ and a lesion size of more than ۳ cm is more common in patients with treatment failure.

کلیدواژه ها:

Cutaneous leishmaniasis ، antimony compounds ، systemic treatment ، treatment failure