Chloroquine in cutaneous leishmaniasis

Background Chloroquine is an antiprotozoal drug that has shown a favorable therapeutic index for cutaneous leishmaniasis. Objective A clinical trial was conducted to determine the efficacy of oral chloroquine in patients with cutaneous leishmaniasis and its comparison with the most effective standard treatment, pentavalent antimony compounds. Patients and methods This non randomized, open-label comparison study was conducted in department of dermatology, Pakistan Institute of Medical Sciences, Islamabad, from August 2006 to January 2007. 30 patients, 12 years of age or older were enrolled in the study. Diagnosis was made on the basis of clinical features and histopathological examination. 15 patients received orally administered chloroquine 250mg tds for 20 days and remaining 15 patients received injectable pentavalent antimony 20mg/kg for 28 days. Pre-treatment complete physical examination was done along with necessary laboratory investigations in all cases. They were repeated after 2 weeks and then at the end of treatment to note any abnormality developing. Groups were almost matched in terms of age, duration of lesions and number of lesions. The efficacy was evaluated by the appearance of the lesion and healing with or without scar formation. Patients were followed up for 3 months. Results All patients completed the study without any complication. Lesions healed completely with only minimal scarring or post-inflammatory hyperpigmentation at the site of lesion. The cure rate at 3-month follow-up was 100% in group A (chloroquine) and 93% in group B (antimony compound) at the end of treatment period. Conclusion Chloroquine seems to be a safe and effective alternative to antimony compounds. The striking advantage of chloroquine being its benefit of oral administration, and low cost along with easy availability which is of particular importance in underdeveloped countries like Pakistan