title: American cutaneous leishmaniasis unresponsive to antimonial drugs: successful treatment using combination of N-methilglucamine antimoniate plus pentoxifylline.
abstract: BACKGROUND
  American cutaneous leishmaniasis is characterized by single or multiple ulcerations. Cytokines, among other factors, have been shown to influence lesion development and tumoral necrosis factor-alpha is a major cytokine implicated in pathogenesis of ulcers.
  
  
  METHODS
  We tested oral pentoxifylline, a known tumoral necrosis factor-alpha inhibitor, at doses of 400 mg (2-3x/day), associated to N-methylglucamine antimoniate (15 mg/kg/day) in two patients with American cutaneous leishmaniasis unresponsive to antimonial drugs. We observed a satisfactory response with quick cure of skin lesions of these patients.
  
  
  CONCLUSIONS
  Our results suggest that oral pentoxifylline in association to N-methylglucamine antimoniate should be consider in refractory cutaneous leishmaniasis patients.
authors.affiliation: Faculdade de Medicina da Universidade Federal da Bahia, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Báfica
authors.forename: Fabiano
authors.initials: F
authors.lastname: Oliveira
authors.forename: Luiz A R
authors.initials: LA
authors.lastname: Freitas
authors.forename: Eliane G
authors.initials: EG
authors.lastname: Nascimento
authors.forename: Aldina
authors.initials: A
authors.lastname: Barral
mesh_terms: D000284:Administration, Oral; D000981:Antiprotozoal Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008536:Meglumine / Q000008:administration & dosage*; D000077485:Meglumine Antimoniate; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage*; D010431:Pentoxifylline / Q000008:administration & dosage*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000378:metabolism
chemical_list: D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D014409:Tumor Necrosis Factor-alpha; D008536:Meglumine; D000077485:Meglumine Antimoniate; D010431:Pentoxifylline