Efficacy of a weekly cryotherapy regimen to treat Leishmania major cutaneous leishmaniasis

BackgroundAntileishmanial chemotherapy can have adverse effects and may fail to cure patients with cutaneous leishmaniasis (CL).ObjectiveTo evaluate the efficacy of a weekly cryotherapy regimen in patients with confirmed Leishmania major infection.MethodsOne hundred twenty Jordanian patients with 375 lesions were treated with cryotherapy performed once weekly in 1 to 7 sessions. This regimen was adopted since living parasites were recovered, in several CL patients, even after 3 cryosessions. Scarring was assessed in 78 patients 3 years after treatment.ResultsApproximately 84% of the lesions were cured after 1 to 4 sessions. The remaining lesions (16.3%) were cured after an additional 1 to 3 session(s). Cryotherapy caused mild adverse side effects and most of the patients were cured with negligible scarring. Statistically, the lesion size and location significantly affected the clinical response to cryotherapy.LimitationsA fraction of patients was followed up 3 years after healing.ConclusionCryotherapy with weekly intervals for 1 to 4 sessions is effective to treat L major CL, especially for smaller lesions. Extra sessions may be necessary to cure larger lesions. The cosmetic results are very good and no relapses were registered.