Successful treatment of drug-resistant cutaneous leishmaniasis in humans by use of imiquimod, an immunomodulator

Treatment failures for leishmaniasis with pentavalent antimonials, includin g meglumine antimonate, are increasingly common in many endemic areas. Imiq uimod (Aldara; 3M Pharmaceuticals) is a novel immune response-activating co mpound, approved by the United States Food and Drug Administration, that is currently used to treat cervical warts and has been shown to activate macr ophage killing of Leishmania species. Therefore, an open-label, prospective study was conducted of combined imiquimod plus meglumine antimonate therap y in 12 patients with cutaneous leishmaniasis who had previously not respon ded to meglumine antimonate therapy. All of the patients responded well to this combination therapy, and 90% were found to be cured at the 6-month fol low-up period.