Cutaneous Leishmaniasis: Treatment Options and Possibilities for Drug Repurposing

Abstract

Leishmaniasis is a tropical disease caused by aprotozoan which is obligate intracellular parasite belongs to the genus Leishmania. There are 3 forms of the disease: visceral leishmaniasis, cutaneous leishmaniasis which is the most common, and mucocutaneous leishmaniasis. The most important compounds used to treat leishmaniasis were meglumine antimoniate (e.g. glucantime), sodium stibogluconate (e.g. pentostam) and pentavalent antimonials. There are other drugs that may be used such as pentamidine and amphotericin B. Until now, the pentavalent antimonial compounds remain the corner stone in the treatment of cutaneous leishmaniasis although this group possesses high degree of toxicity. Other treatment options include the pentamidines and liposomal amphotericin B (AmBisome). Combination therapies using AmBisome and miltefosine are another effective alternative to antimonial compounds. Other latest therapeutic options include photodynamic therapy, tamoxifen and imiquimod. The proper choice of antileishmanial therapy depends on the geographic location, host immune status, availability of the drug, and expertise of the treating physician. The present review summarizes the current treatment options available for cutaneous leishmaniasis as well as some drugs on the horizon that show promising results in the treatment of cutaneous leishmaniasis.