Evaluation of CO2 laser efficacy in the treatment of cutaneous leishmaniasis

• Published in: International journal of dermatology 2004-10, Vol.43 (10), p.736-738
• Main Authors: Asilian, A., Sharif, A., Faghihi, G., Enshaeieh, Sh, Shariati, F., Siadat, A. H.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Human protozoal diseases; Infectious diseases; Leshmaniasis; Medical sciences; Parasitic diseases; Protozoal diseases
• ISSN: 0011-9059; 1365-4632
• DOI: 10.1111/j.1365-4632.2004.02349.x

Background  Cutaneous leishmaniasis is a common disease in Iran, especially in the north‐east, central and southern parts of the country. Many treatments have been suggested for this disease but none is completely effective and without side‐effects such as pain, arthralgia and renal or cardiac complications. Lasers have been used for treatment of several skin diseases since 1970, and CO2 lasers are now being used for treatment of leishmaniasis. In this study, a CO2 laser (Sonic 500 machine) was used as a source of a continuous CO2 laser wave. Methods  A total of 123 patients (68 female and 55 male) with 183 lesions were treated with the CO2 laser. The maximum power was 100 W and the pulse width was 0.5–5 s. For the control group, 110 patients (with 250 lesions) were treated with glucantime 50 mg/kg/day for 15 days and, after 15 days of rest, this treatment was repeated (Glucantime Amps, 1.5 g in a 50‐mL solution, was used). For follow‐up, the patients were visited 1, 3, 4, 8, 12 and 24 weeks after treatment and any complications, recurrences or other wound characteristics were recorded. In the second group, Finally, all collected data were analyzed statistically. Results  Statistical analysis with the χ2 test showed that treatment with the CO2 laser was more effective than treatment with glucantime (P = 0.0007). Complications were also seen less often with the laser treatment than with glucantime and were limited to the ulcer site. The CO2 laser was more effective in treating cutaneous leishmaniasis than glucantime (1.12 times), had fewer side‐effects (4.5% vs. 24%) and resulted in a shorter healing time (1 month vs. 3 months), and treatment could be applied in a single session. Conclusions  The results of this and previous studies suggest that cutaneous leishmaniasis can be treated effectively with CO2 laser if those providing the treatment are sufficiently experienced. Laser treatment is more cost‐effective than other treatments and can be used as first‐line therapy for cutaneous leishmaniasis (wet and dry types).