Faris R M, Jarallah J S, Khoja T A, al-Yamani M J
Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Int J Dermatol. 1993 Aug;32(8):610-2. doi: 10.1111/j.1365-4362.1993.tb05044.x.
Cutaneous leishmaniasis represents a difficult disease to manage in endemic areas. Systemic treatment is hampered by both expense and compliance. Side effects may play a major role in this aspect as well.
The effectiveness of intralesional treatment of leishmaniasis was investigated. Seven hundred and ten patients were treated with injections of sodium stibogluconate intralesionally. The clinical diagnosis was confirmed by demonstrating the parasite in the smears obtained from the lesion. Fine insulin needle was used to infiltrate the lesion with sodium stibogluconate (0.5 to 1.0 mL).
Generally eight injections were sufficient, but some of the complicated lesions needed up to 24 injections. Sixty-two percent of patients were men. The majority of the study population (64%) were children below 15 years of age. The results showed that 72% of lesions healed completely, 23.9% showed some improvement, while 4.1% showed some deterioration. Lesions of the lips, cheeks, chin, and neck healed faster than lesions in other parts of the body. Side effects were mild and limited to pain at the site of the injection and hyperpigmentation in those who were treated by folk medicine.
Intralesional treatment is as effective as the standard systemic antimonials. It offers a less expensive alternative and a low side effects profile. Our findings confirmed the findings of earlier workers. It is recommended for treatment of cutaneous leishmaniasis in endemic areas.
皮肤利什曼病在流行地区是一种难以治疗的疾病。全身治疗受到费用和依从性的阻碍。副作用在这方面也可能起主要作用。
研究了皮损内注射治疗利什曼病的有效性。710例患者接受了皮损内注射葡萄糖酸锑钠治疗。通过在从病变处获取的涂片中发现寄生虫来确诊临床诊断。使用胰岛素细针将葡萄糖酸锑钠（0.5至1.0毫升）注入病变处。
一般八次注射就足够了，但一些复杂病变需要多达24次注射。62%的患者为男性。研究人群的大多数（64%）为15岁以下儿童。结果显示，72%的病变完全愈合，23.9%有一定改善，而4.1%有一定恶化。嘴唇、脸颊、下巴和颈部的病变比身体其他部位的病变愈合得更快。副作用轻微，仅限于注射部位疼痛以及接受民间疗法治疗的患者出现色素沉着。
皮损内治疗与标准的全身抗锑剂治疗效果相同。它提供了一种更便宜的替代方法且副作用较少。我们的研究结果证实了早期研究者的发现。建议在流行地区用于治疗皮肤利什曼病。
