Intralesional therapy of American cutaneous leishmaniasis with pentavalent antimony in Rio de Janeiro, Brazil – an area of Leishmania (V.) braziliensis transmission

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Abstract
Background The drug of choice for leishmaniasis is pentavalent antimony and different regimens are under continuous evaluation. The ideal therapy should be simple, effective, and with no or minor side‐effects, in this paper we have studied the efficacy of intralesionally applied antimony in New World cutaneous leishmaniasis. Methods Seventy‐four patients from Rio de Janeiro state, Brazil, and presenting with single ulcerative cutaneous lesions mainly located on the trunk or extremities were enrolled in the study. The drug employed was N‐methyl glucamine (425 mg of Sbv in each 5 ml ampoule). Each lesion was infiltrated with the drug at the four cardinal points in order to achieve complete blanching. Results Of the 74 patients, 59 (80%) were healed after a 12–week interval. Extensive follow‐up (up to 10 years) disclosed no relapses or the development of mucosal lesions. Conclusions The aim of therapy in New World cutaneous leishmaniasis is the healing of the cutaneous lesion and the prevention of late mucosal damage. Both conditions were achieved with the treatment employed with no side‐effects and a considerable decrease in costs. In addition, the method is easy to apply in the field.