Noaimi Adil A, Mohamed Maryam
Department of Dermatology and Venereology, College of Medicine, University of Baghdad, Baghdad, IRQ.
Department of Dermatology and Venereology, Baghdad Center of Dermatology and Venereology, Medical City, Baghdad, IRQ.
Cureus. 2025 May 22;17(5):e84618. doi: 10.7759/cureus.84618. eCollection 2025 May.
Background and objective Cutaneous leishmaniasis (CL) is one of the most significant and endemic parasitic infections in many regions around the world, and it is caused by several species of the Leishmania parasite. It is a morbid condition that leads to stigmatization and disfiguring scars. Numerous methods have been tried to treat leishmaniasis with variable cure rates and side effects. This study aimed to compare the effects of oral zinc bisglycinate (ZnGly) and oral hydroxychloroquine sulfate (HCQ), alone and in combination, in treating acute CL. Materials and methods This comparative therapeutic study was conducted at the Center of Dermatology and Venereology, Medical City, Baghdad, Iraq, during the period from December 2021 to February 2023. All participants had been diagnosed through history and clinical examination, which involved skin smear in all patients and skin biopsy for some suspicious cases. Patients were classified into three groups based on the type of treatment: Group A was treated with oral ZnGly capsules 50 mg twice daily for eight weeks; Group B was administered oral HCQ tablets 200 mg twice daily for eight weeks; and Group C received a combination of both drugs for eight weeks. All patients were examined every four weeks for eight weeks, followed by every month for two months after stopping therapy. The treatment's impact on the lesions was assessed using Sharquie`s modified Leishmania score. Results A total of 40 patients with acute CL were included in this study, which spanned eight weeks. The total number of lesions was 144, and their duration ranged from five to 12 weeks. Group A included 14 patients, and the cure rate was 78.6% (11); Group B included 13 patients, and the cure rate was 84.7 % (11), while Group C included 13 patients, and the cure rate was 92.3% (12). We observed a statistically significant difference in the cure rate in Group C when compared to Group A and Group B at the end of the study (p=0.034). Conclusions While both oral ZnGly and HCQ as monotherapy were effective in the treatment of acute CL, the combination regimen of both drugs led to higher effectiveness without any increase in the frequency of adverse effects.
背景与目的 皮肤利什曼病（CL）是世界上许多地区最严重的地方性寄生虫感染之一，由几种利什曼原虫寄生虫引起。它是一种会导致污名化和毁容性疤痕的疾病。人们尝试了许多方法来治疗利什曼病，治愈率和副作用各不相同。本研究旨在比较口服甘氨酸锌（ZnGly）和口服硫酸羟氯喹（HCQ）单独及联合使用治疗急性CL的效果。材料与方法 这项对比治疗研究于2021年12月至2023年2月在伊拉克巴格达医疗城皮肤病与性病中心进行。所有参与者均通过病史和临床检查进行诊断，所有患者均进行皮肤涂片检查，部分可疑病例进行皮肤活检。根据治疗类型将患者分为三组：A组每天口服50mg甘氨酸锌胶囊两次，持续八周；B组每天口服200mg硫酸羟氯喹片两次，持续八周；C组接受两种药物联合治疗八周。所有患者在八周内每四周检查一次，治疗停止后接下来的两个月每月检查一次。使用沙尔基改良的利什曼病评分评估治疗对病变的影响。结果 本研究共纳入40例急性CL患者，为期八周。病变总数为144个，病程为5至12周。A组包括14例患者，治愈率为78.6%（11例）；B组包括13例患者，治愈率为84.7%（11例），而C组包括13例患者，治愈率为92.3%（12例）。在研究结束时，与A组和B组相比，我们观察到C组的治愈率有统计学显著差异（p=0.034）。结论 虽然口服甘氨酸锌和硫酸羟氯喹作为单一疗法对急性CL的治疗均有效，但两种药物的联合方案导致更高的疗效，且不良反应发生率没有增加。
