Chemotherapy of cutaneous leishmaniasis: a review

A wide variety of treatment modalities have been employed for cutaneous lei shmaniasis (CL); however, none has been demonstrated to be good enough to b e used as the first-line drug to treat patients in all the CL epidemiologic al scenarios. Although pentavalent antimonials remain a drug widely used in the treatment of all forms of leishmaniasis, they are far from being satis factory. A great variety of topical treatments have been used to treat CL. However, the majority of these modalities have been tested in non-controlle d studies, with only few subjects and the interpretation of results is usua lly difficult due to the lack of a standard and well-accepted cure definiti on. Several oral drugs, such as ketoconazole and itraconazole, have also be en tested for CL, but results obtained were not completely satisfactory. As of today, miltefosine, originally developed as an oral antineoplastic agen t. seems, from the preliminary results obtained in different phase II clini cal studies, to be the most promising oral drug developed during the last d ecade.