Topical Treatment of Cutaneous Leishmaniasis in Israel, Part 3.

Cutaneous leishmaniasis is the most common form of leishmaniasis with global incidence of about 1.5 million cases annually. The disease is endemic in Israel and caused by two types, leishmania major and leishmania tropica. The two types of cutaneous leishmaniasis in Israel are not life threatening, but the multiple skin lesions developed from the contaminated sandfly bites cause significant damage to the quality of life for a few months in patients with leishmania major and sometimes for more than a year in patients with leishmania tropica. Topical treatment for this localized skin disease is very attractive although only one medication is registered in Israel (15% paromomycin +12% methylbenzethonium chloride ointment) for the topical treatment of leishmania major. Two significant disadvantages characterize this topical medication, 1) relatively low efficacy and 2) significant irritation and pain. This article represents part 3 of a 3-part article on the topic of cutaneous leishmaniasis. Part 1 discussed the treatment option of amphotericin-B liposomal gel, part 2 discussed the treatment option of paromomycin sulfate liposomal gel, and this final part (3) discusses the treatment option of photodynamic therapy.