Combined intralesional and intramuscular sodium stibogluconate appears more effective in the treatment of localized cutaneous leishmaniasis lesions, An experimental study

Background Intralesional sodium stibogluconate (SSG) has become the first line therapy for localized cutaneous leishmaniasis (LCL). The objective of this study was to compare the efficacy of intralesional SSG given alone with that of intralesional SSG combined with intramuscular SSG. Methods This randomized controlled intervention study was conducted at the Department of Dermatology, King Khalid Hospital in Najran, Saudi Arabia. A total of 40 patients with LCL were assigned randomly to Group-1 (n=20) or Group-2 (n=20). Group-1 received three injections of intralesional SSG on alternate days, while Group-2 received three injections of intralesional SSG similar to Group-1 and the rest of the calculated dose as a simultaneous intramuscular injection. Five treatment cycles were carried out through monthly follow-up visits during subsequent five months to assess the treatment outcome in both groups. Results The patients in Group-2 showed overall better improvement than that of the patients in Group-1 in all treatment cycles. Most of the plaque lesions, multiple lesions and mucosal lesions were cured after 1 to 2 treatment cycles in Group-2, compared to the patients in Group-1 having similar lesions required 2 or more cycles for cure. The resultant scarring after healing among the patients in Group-2 was even and cosmetically more acceptable than that was observed among the patients in Group-1. Conclusion Combination regimen of intralesional and intramuscular SSG appeared to be more effective than intralesional SSG given alone in the treatment of LCL.