Comparison of Injection Meglumine Antimoniate with a Combination of Injection Meglumine Antimoniate and Carbon Dioxide Fractional Ablative Laser in Treatment of Cutaneous Leshmaniasis

Abstract

Aim: To see the efficacy of meglumine antimoniate alone in comparison with combination of meglumine antimoniate and CO₂ ablative laser among patients with cutaneous leishmaniasis.

Study design: Quasi-experimental study.

Place and duration of study: Department of Dermatology, Pakistan Emirates Military Hospital, Rawalpindi from 9^th July 2020 to 8^th January 2021.

Methodology: Sixty patients (30 in each group) diagnosed cases of cutaneous leishmaniasis by skin biopsy or slit skin smear were enrolled. In group A; intramuscular injection of meglumine antimoniate (dose 20 mg/kg daily) was administered for 28 days and group B was treated with intramuscular meglumine antimoniate injection along with fractional C0₂ ablative laser. Standard digital photography was done before start of treatment and then every 2 weeks. 

Results: Efficacy of meglumine antimoniate alone was observed in 60% of patients while it was 86.7% when combined with fractional CO₂ ablative laser. Better outcome was observed when such patients were treated with both meglumine antimoniate and fractional CO₂ laser. Efficacy was measured after 6 x weeks in all patients of both groups.

Clinical Implication: Hence CO₂ lasers are latest modality of treatment with minimal side effects and can be used in treatment of patients with cutaneous leishmaniasis.

Conclusion: Efficacy of meglumine antimoniate plus fractional CO₂ laser found to be higher as compared to meglumine antimonate alone in treating cutaneous leishmaniasis.

Keywords: Cutaneous leishmaniasis, CO₂ fractional ablative laser, Meglumine antimoniate, Slit skin smear