title: Safety and efficacy of current alternatives in the topical treatment of cutaneous leishmaniasis: a systematic review.
abstract: Studies of topical treatments for leishmaniasis were systematically reviewed, to evaluate the therapeutic efficacy, safety and any adverse effects of these treatments. The papers identified in the databases PubMed and Web of Knowledge involved eight studies with a total of 1744 patients. The majority of trials was from Iran (4/8), covered a period of 8 years (2003-2011), and included patients 4-85 years of age. The most frequent Leishmania species in the studies were L. tropica (4/8) and L. major (2/8). The treatments administered were thermotherapy, paromomycin and combinations, CO2 laser, 5-aminolevulinic acid hydrochloride (10%) plus visible red light (633 nm) and cryotherapy. Six articles reported cure rates over 80·0%. Six studies reported on failure rates, three of them reporting rates lower than 10%. Four studies did not report relapses or recurrences, while the other studies reported low rates (1·8-6·3%). The most common adverse effects of the topical treatments were redness/erythema, pain, pruritus burning, oedema, vesicles and hyper- or hypopigmentation. The results provide strong evidence that the treatments topical evaluated showed high cure rates, safety and effectiveness, with low side-effects, relapse and recurrence rates, except for cryotherapy, which showed a moderate cure rate.
authors.affiliation: Graduate Program in Health Sciences,State University Maringa,Avenida Colombo, 5790, Jardim Universitário, CEP 87020-900, Maringá, Paraná,Brazil.
authors.forename: Priscila
authors.initials: P
authors.lastname: Wolf Nassif
authors.affiliation: Graduate Program in Bioscience and Physiopathology,State University Maringa,Avenida Colombo, 5790, Jardim Universitário, CEP 87020-900, Maringá, Paraná,Brazil.
authors.forename: Tatiane França Perles
authors.initials: TFP
authors.lastname: DE Mello
authors.affiliation: Graduate Program in Health Sciences,State University Maringa,Avenida Colombo, 5790, Jardim Universitário, CEP 87020-900, Maringá, Paraná,Brazil.
authors.forename: Taísa Rocha
authors.initials: TR
authors.lastname: Navasconi
authors.affiliation: Graduate Program in Bioscience and Physiopathology,State University Maringa,Avenida Colombo, 5790, Jardim Universitário, CEP 87020-900, Maringá, Paraná,Brazil.
authors.forename: Camila Alves
authors.initials: CA
authors.lastname: Mota
authors.affiliation: Graduate Program in Health Sciences,State University Maringa,Avenida Colombo, 5790, Jardim Universitário, CEP 87020-900, Maringá, Paraná,Brazil.
authors.forename: Izabel Galhardo
authors.initials: IG
authors.lastname: Demarchi
authors.affiliation: Department of Clinical Analysis and Biomedicine,State University Maringa,Avenida Colombo, 5790, Jardim Universitário, CEP 87020-900, Maringá, Paraná,Brazil.
authors.forename: Sandra Mara Alessi
authors.initials: SMA
authors.lastname: Aristides
authors.affiliation: Department of Clinical Analysis and Biomedicine,State University Maringa,Avenida Colombo, 5790, Jardim Universitário, CEP 87020-900, Maringá, Paraná,Brazil.
authors.forename: Maria Valdrinez Campana
authors.initials: MVC
authors.lastname: Lonardoni
authors.affiliation: Department of Clinical Analysis and Biomedicine,State University Maringa,Avenida Colombo, 5790, Jardim Universitário, CEP 87020-900, Maringá, Paraná,Brazil.
authors.forename: Jorge Juarez Vieira
authors.initials: JJV
authors.lastname: Teixeira
authors.affiliation: Department of Clinical Analysis and Biomedicine,State University Maringa,Avenida Colombo, 5790, Jardim Universitário, CEP 87020-900, Maringá, Paraná,Brazil.
authors.forename: Thaís Gomes Verzignassi
authors.initials: TGV
authors.lastname: Silveira
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000981:Antiprotozoal Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D006979:Hyperthermia, Induced; D054020:Lasers, Gas / Q000009:adverse effects; D007891:Leishmania / Q000187:drug effects / Q000528:radiation effects; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy*; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000981:Antiprotozoal Agents
keywords: 
                 Leishmania
              ; Antiprotozoal agents; clinical trials; cutaneous leishmaniasis; leishmaniasis