Department of Dermatology, Tel Aviv Medical Center, Tel Aviv, 6423906, Israel.
Acta Derm Venereol. 2019 Jan 1;99(1):53-57. doi: 10.2340/00015555-3058.
Conventional treatment of cutaneous leishmaniasis often leaves permanent scars with frequent psychosocial sequelae. The aim of this study was to compare the efficacy, safety, associated pain and final cosmetic outcome of fractional carbon dioxide (CO2) laser followed by topical application of sodium stibogluconate vs. sodium stibogluconate injections for the treatment of cutaneous leishmaniasis. A total of 181 lesions (20 patients) were randomly assigned to receive intralesional injections of sodium stibogluconate (control group) or fractional CO2 laser treatment followed by topical application of sodium stibogluconate (study group). The visual analogue scale (VAS) score of the control group was much higher than that of the study group (6.85 vs. 3.5, respectively, p<0.001). Both the patients and 2 blinded dermatologists found the final cosmetic outcome to be superior for laser-treated lesions (p = 0.001 vs. p =0.008 for controls). Fractional CO2 laser treatment followed by topical application of sodium stibogluconate is less painful and leads to a better final cosmetic outcome compared with intralesional injections of sodium stibogluconate.
常规的皮肤利什曼病治疗方法常常会留下永久性疤痕，并伴有频繁的心理社会后遗症。本研究旨在比较二氧化碳（CO2）激光分束治疗后局部涂抹葡萄糖酸锑钠与局部注射葡萄糖酸锑钠治疗皮肤利什曼病的疗效、安全性、相关疼痛和最终美容效果。共有 181 处病变（20 例患者）被随机分为接受局部注射葡萄糖酸锑钠（对照组）或 CO2 激光分束治疗后局部涂抹葡萄糖酸锑钠（研究组）。对照组的视觉模拟评分（VAS）明显高于研究组（分别为 6.85 和 3.5，p<0.001）。患者和 2 名盲法皮肤科医生均认为激光治疗后的病变美容效果更好（p=0.001 与 p=0.008，对照组）。与局部注射葡萄糖酸锑钠相比，CO2 激光分束治疗后局部涂抹葡萄糖酸锑钠的疼痛更小，且最终美容效果更好。
