Khatami Alireza, Firooz Alireza, Gorouhi Farzam, Dowlati Yahya
Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Iran.
J Am Acad Dermatol. 2007 Aug;57(2):335.e1-29. doi: 10.1016/j.jaad.2007.01.016. Epub 2007 Mar 6.
Cutaneous leishmaniasis (CL) is caused by different species of Leishmania and transmitted by the bite of infected sand flies. It is a health problem in many countries.
This study was performed to assess the evidence for the efficacy of different therapeutic modalities for acute Old World CL, which is usually caused by L major and L tropica.
Evidence was reviewed according to the hierarchy of evidence. Because there have been no published systematic reviews on this topic to date, the primary source of evidence was individual randomized controlled trials (RCTs). Multiple databases were systematically searched. Using independent double review and published quality review criteria, articles were rated as good, fair, or poor. Treatment benefit data were tabulated, and conclusions were based on the rated strength of published evidence.
In all, 50 RCTs met inclusion criteria consisting of 5515 patients in 119 study arms. Reviewed trials were highly variable in quality and methods and generally provide weak evidence for treatment of acute Old World CL.
The quality of included studies was generally poor.
Well-designed randomized, double-blind, controlled trials should be designed and conducted to find better evidence for the treatment of acute Old World CL.
皮肤利什曼病（CL）由不同种类的利什曼原虫引起，通过受感染白蛉叮咬传播。在许多国家，它都是一个健康问题。
本研究旨在评估不同治疗方式对急性旧世界CL（通常由大型利什曼原虫和热带利什曼原虫引起）疗效的证据。
根据证据等级对证据进行综述。由于目前尚无关于该主题的已发表系统综述，证据的主要来源是个体随机对照试验（RCT）。系统检索了多个数据库。采用独立双审和已发表的质量评审标准，将文章评为优、良或差。将治疗获益数据制成表格，并根据已发表证据的评定强度得出结论。
共有50项RCT符合纳入标准，包括119个研究组中的5515名患者。所综述的试验在质量和方法上差异很大，总体上为急性旧世界CL的治疗提供了薄弱的证据。
纳入研究的质量普遍较差。
应设计并开展设计良好的随机、双盲、对照试验，以找到治疗急性旧世界CL的更好证据。
