Rhinophyma-Like Cutaneous Leishmaniasis due to Leishmania aethiopica Treated Successfully with Liposomal Amphotericin B

ABSTRACTDisfiguring skin lesions caused by several species of theLeishmaniaparasite characterize cutaneous leishmaniasis (CL). Successful treatment of CL with intravenous (i.v.) liposomal amphotericin B (LAmB) relies on the presence of adequate antibiotic concentrations at the dermal site of infection within the inflamed skin. Here, we have investigated the impact of the local skin inflammation on the pharmacokinetics (PK) and efficacy of LAmB in two murine models of localized CL (Leishmania majorandLeishmania mexicana) at three different stages of disease (papule, initial nodule, and established nodule). Twenty-four hours after the administration of one 25 mg/kg of body weight LAmB (i.v.) dose to infected BALB/c mice (n= 5), drug accumulation in the skin was found to be dependent on the causative parasite species (L. major>L. mexicana) and the disease stage (papule > initial nodule > established nodule > healthy skin). Elevated tissue drug levels were associated with increased vascular permeability (Evans blue assay) and macrophage infiltration (histomorphometry) in the infected skin, two pathophysiological parameters linked to tissue inflammation. After identical treatment of CL in the two models with 5 × 25 mg/kg LAmB (i.v.), intralesional drug concentrations and reductions in lesion size and parasite load (quantitative PCR [qPCR]) were all ≥2-fold higher forL. majorthan forL. mexicana. In conclusion, drug penetration of LAmB into CL skin lesions could depend on the disease stage and the causativeLeishmaniaspecies due to the influence of local tissue inflammation.

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Atypical multifocal cutaneous leishmaniasis in an immunocompetent patient treated by liposomal amphotericin B

Journal of Infection ◽

10.1016/j.jinf.2005.03.012 ◽

2005 ◽

Vol 51 (5) ◽

pp. e261-e264 ◽

Cited By ~ 16

Author(s):

A. Paradisi ◽

R. Capizzi ◽

A. Zampetti ◽

I. Proietti ◽

C. De Simone ◽

...

Keyword(s):

Cutaneous Leishmaniasis ◽

Amphotericin B ◽

Liposomal Amphotericin ◽

Immunocompetent Patient ◽

Liposomal Amphotericin B

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A Targeted and Adjuvanted Nanocarrier Lowers the Effective Dose of Liposomal Amphotericin B and Enhances Adaptive Immunity in Murine Cutaneous Leishmaniasis

The Journal of Infectious Diseases ◽

10.1093/infdis/jit378 ◽

2013 ◽

Vol 208 (11) ◽

pp. 1914-1922 ◽

Cited By ~ 33

Author(s):

Pirouz M. Daftarian ◽

Geoffrey W. Stone ◽

Leticia Kovalski ◽

Manoj Kumar ◽

Aram Vosoughi ◽

...

Keyword(s):

Effective Dose ◽

Cutaneous Leishmaniasis ◽

Amphotericin B ◽

Adaptive Immunity ◽

Liposomal Amphotericin ◽

Liposomal Amphotericin B ◽

Murine Cutaneous Leishmaniasis

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Recidivans cutaneous leishmaniasis unresponsive to liposomal amphotericin B (AmBisomeR)

Journal of the European Academy of Dermatology and Venereology ◽

10.1046/j.1468-3083.2000.00004.x ◽

2000 ◽

Vol 14 (1) ◽

pp. 11-13 ◽

Cited By ~ 14

Author(s):

Kamer Gunduz ◽

Sule Afsar ◽

Semin Ayhan ◽

Ali Riza Kandiloglu ◽

Aylin Turel ◽

...

Keyword(s):

Cutaneous Leishmaniasis ◽

Amphotericin B ◽

Liposomal Amphotericin ◽

Liposomal Amphotericin B

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Combination of topical liposomal amphotericin B and Glucantime in comparison with glucantime alone for the treatment of anthroponotic cutaneous leishmaniasis (ACL) caused by Leishmania tropica: study protocol for a randomized, controlled trial

Iranian Journal of Microbiology ◽

10.18502/ijm.v13i5.7440 ◽

2021 ◽

Author(s):

Seyed Ebrahim Eskandari ◽

Ali Khamesipour ◽

Mahmoud Reza Jaafari ◽

Amir Javadi ◽

Akram Miramin Mohammadi ◽

...

Keyword(s):

Cutaneous Leishmaniasis ◽

Amphotericin B ◽

Liposomal Amphotericin ◽

Controlled Trial ◽

Liposomal Amphotericin B ◽

Topical Formulation ◽

Liposomal Form ◽

Double Blind ◽

Well Design ◽

Intralesional Injections

Background and Objectives: Cutaneous leishmaniasis (CL) treatment is a challenging issue, although numerous modalities have been introduced as candidate treatment for CL yet only antimonial agents are commonly used to treat CL, a different form of amphotericin B is used to treat visceral form of leishmaniasis but the efficacy against CL is not high. There are a few reliable clinical trials on CL, the main reason is the nature of the disease which required a well design protocol to evaluate the efficacy of any candidate treatment against CL. In this study, a protocol was developed and used to evaluate a topical formulation of a nano-liposomal form of amphotericin B in addition to glucantime to treat CL caused by L. tropica. Materials and Methods: This study is a phase 3, randomized, double-blind, placebo-controlled trial to evaluate the efficacy and safety of topical nano-liposomal amphotericin B (SinaAmpholeish 0.4%) in combination with intralesional injections of meglumine antimoniate in the treatment of ACL caused by L. tropica. Overall, 130 patients, aged 12-60 years, with a diag- nosis of ACL caused by L. tropica are recruited and treated according to the protocol. Results: A total of 130 patients with CL lesion will be recruited and double- blind randomly treated with received intralesional injections of Glucantime weekly or Glucantime plus SinaAmpholeish for 4 weeks. Conclusion: The results of this study showed that the protocol works well and the treatment was tolerated by both groups of patients.

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