Efficacies of Intralesional Zinc Sulphate and Hypertonic Sodium Chloride in the Treatment of Acute C

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Efficacies of Intralesional Zinc Sulphate and
Hypertonic Sodium Chloride in the Treatment of
Acute Cutaneous Leishmaniasis
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HUSSEIN A. HUSSEIN, MOHAMED H. A. EL BAKRY AND
KHALIFA E. KHALIFA
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• Pentavalent antimonials are the mainstay drugs
  for systemic and intralesional treatment of
  cutaneous leishmaniasis.
• However, these drugs as well as other drugs, are
  expensive and may be associated with numerous
  side effects.
• 2 zinc sulphate and 7 sodium chloride were
  tried for intralesional therapy of acute
  cutaneous leishmaniasis and found to have high
  cure rates.

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AIM OF THE WORK
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• The present study aims at
• Evaluation of the ant-leishmanial effects of
  intralesional zinc sulphate and hypertonic sodium
  chloride.
• Comparison of their efficacies with that of the
  standard pentavalent antimony compound,
  pentostam.

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• PATIENTS AND METHODS

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Study groups

• Patients with confirmed acute cutaneous
  leishmaniasis were enrolled in the study.
  Admission criteria included
• Single or few skin lesions
• Less than 12 weeks
• Detection of amastigotes by direct smear in
  lesions taken from the base of the edge of the
  ulcer
• Cases of reinfection were excluded

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Study groups (cont.)

• 97 patients were initially selected and randomly
  distributed into three treatment groups
• 2 zinc sulphate (w/v)
• 7 sodium chloride (w/v)
• Sodium stibogluconate (Pentostam, Wellcome)
• Of these 59 completed the study.

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Follow up

• Patients were followed up every 15 days for 45
  days. At each visit the lesions were re-examined
  and the response was graded into
• No cure slight clinical improvement.
• Mild cure decrease in the size of the ulcer by
  less than 30 without disappearance of the
  parasite from the lesion by direct smear method
  and culture as examined blindly.
• Cure decrease in the of the ulcer by more than
  60, confirmed by disappearance of the parasite.

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Clinical characteristics of the study groups
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RESULTS
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Percentages of lesions cure in the three groups
under study
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Percentages of cured lesions after one, two and
three drugs injections.
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Giemsa-stained amastigotes (x 1000) in skin
smears from patients with clinically suspected
cut. leishmaniasis
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Giemsa-stained promastigotes (x 1000) after 2
weeks cultivation on NNN medium
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Skin lesions before treatment



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Healing and healed skin lesions after treatment



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CONCLUSION
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• 2 zinc sulphate and 7 sodium chloride are
• Effective (93.8 and 85.6)
• Safe
• Economic
• For intralesional treatment of few lesions acute
  cutaneous leishmaniasis

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