Abstract

Leishmaniasis is a vector-borne disease caused by flagellated protozoans belonging to the genus Leishmania. Cutaneous leishmaniasis (CL) is a parasitic disease transmitted by sandflies called phlebotomine that causes a variety of skin lesions. It has a wide range of clinical manifestations that are influenced by a number of unknown parasite and host factors. The disease can take many forms, ranging from self-limited and even self-healing cutaneous manifestations to fatal systemic disease. The standard treatment is pentavalent antimony. Pentavalent antimonials are the cornerstones of cutaneous leishmaniasis treatment, with novel oral and topical options on the horizon. Many lesions heal on their own and does not need to be treated. Antimonials are likely to cause a high number of reversible side effects. Other medications used in treatment include amphotericin B, pentamidine isethionate, paromomycin and antifungals. Although the cutaneous version of the disease is frequently self-limiting, it can leave considerable scarring and lead to more invasive mucocutaneous disease. As a result, treatment to prevent these problems may be considered. In endemic regions, leishmania parasites are frequently diagnosed clinically and, if possible, by microscopic inspection of lesion biopsy samples to visually confirm the aetiology. In non-endemic nations, the use of more advanced medical procedures that allow for species identification is mainly limited to research or therapeutic contexts. The application, use and adverse effects of drugs for systemic and topical treatment are also described.

Highlights

  • The epidemiology and clinical features of the disease are highly variable due to the interaction of numerous factors in the parasites, vectors, hosts and environment involved. It manifests itself as a range of clinical syndromes, classified as cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL) [4]

  • diffuse cutaneous leishmaniasis (DCL) is characterised by non-ulcerating lesions which spread to areas including the face and extending surfaces of the limbs locally and hematogenically, and which may cause deep tissue destruction [25]

  • Oral imidazoles are yet another controversial CL treatment that may be considered for use in complex lesions and those with the potential to progress to mucocutaneous leishmaniasis (MCL) [62]

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Summary

A Review on Cutaneous Leishmaniasis

Safeetha Shamsudheen a, Vimal Mathew b*, B. V. Ashira Ali d, Smiya Mathew e and D. Uma Maheswari b a Department of Pharmaceutics, National College of Pharmacy, Manassery, Mukkam Post, Kozhikode, Kerala -673602, India. C Department of Pharmaceutical Chemistry, National College of Pharmacy, Manassery, Mukkam Post, Kozhikode, Kerala -673602, India. D Department of Pharmaceutical Analysis, National College of Pharmacy, Manassery, Mukkam Post, Kozhikode, Kerala -673602, India. E Department of Pharmaceutics, St. Joseph’s College of Pharmacy, Dharmagiri College Campus, Naipunya Road, Cherthala, Alapuzha, 688524, India. This work was carried out in collaboration among all authors. All authors read and approved the final manuscript. Open Peer Review History: This journal follows the Advanced Open Peer Review policy. Identity of the Reviewers, Editor(s) and additional Reviewers, peer review comments, different versions of the manuscript, comments of the editors, etc are available here: https://www.sdiarticle5.com/review-history/75885

EPIDEMIOLOGY
PATHOLOGY
DIAGNOSIS
Leishmania Skin Test
Immunologic Diagnostic Methods
TREATMENT
First-line Therapy
Cryotherapy
Thermotherapy
Treatment during pregnancy and lactation
Azoles
Miltefosine
Parenteral Therapy
Pentamidine
Findings
Amphotericin B
Full Text
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