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Long-term efficacy of single-dose radiofrequency-induced heat therapy vs. intralesional antimonials for cutaneous leishmaniasis in India.
Br J Dermatol. 2013 May; 168(5):1114-9.BJ

Abstract

BACKGROUND

Radiofrequency-induced heat therapy (RFHT) has been found to be safe and effective against cutaneous leishmaniasis (CL) in the short term, but its long-term efficacy is unclear.

OBJECTIVES

To compare the long-term efficacy of RFHT vs. intralesional sodium stibogluconate (SSG) injections in the treatment of CL in India.

METHODS

One hundred patients with a confirmed diagnosis of CL were randomly assigned in a 1 : 1 ratio to receive topical RFHT for 30-60 s or seven intralesional injections of SSG (50 mg cm(-2) of lesion). Improvement and recurrence were monitored every 15 days after the initiation of treatment for 4 months and then at 5, 6, 9, 12 and 18 months post-treatment; the rates of complete cure were compared.

RESULTS

Lesions were healed in 47 out of 50 patients (94%) in the RFHT group and in 46 out of 50 patients (92%) in the SSG group at week 12. Time to complete healing was comparable in the two groups. At 6 months post-treatment, cure rates in the RFHT and SSG groups were 98% [95% confidence interval (CI) 94-100%] and 94% (95% CI 86-100%), respectively. Age, sex and lesion size or number had no effect on cure rates. No relapse of infection was recorded in cured patients in either group up to 12-18 months after initiation of treatment. Skin biopsies of cured lesions in eight out of eight (100%) patients from the RFHT group and three of three from the SSG group at 12 months showed minimal fibrosis and were negative for Leishmania tropica by polymerase chain reaction test.

CONCLUSIONS

A single application of RFHT is safe, cosmetically acceptable and effective in inducing a long-term cure of CL.

Authors+Show Affiliations

Department of Dermatology, PBM Hospital and SP Medical College, Bikaner, Rajasthan, India. dr_bumb@rediffmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

23298394

Citation

Bumb, R A., et al. "Long-term Efficacy of Single-dose Radiofrequency-induced Heat Therapy Vs. Intralesional Antimonials for Cutaneous Leishmaniasis in India." The British Journal of Dermatology, vol. 168, no. 5, 2013, pp. 1114-9.
Bumb RA, Prasad N, Khandelwal K, et al. Long-term efficacy of single-dose radiofrequency-induced heat therapy vs. intralesional antimonials for cutaneous leishmaniasis in India. Br J Dermatol. 2013;168(5):1114-9.
Bumb, R. A., Prasad, N., Khandelwal, K., Aara, N., Mehta, R. D., Ghiya, B. C., Salotra, P., Wei, L., Peters, S., & Satoskar, A. R. (2013). Long-term efficacy of single-dose radiofrequency-induced heat therapy vs. intralesional antimonials for cutaneous leishmaniasis in India. The British Journal of Dermatology, 168(5), 1114-9. https://doi.org/10.1111/bjd.12205
Bumb RA, et al. Long-term Efficacy of Single-dose Radiofrequency-induced Heat Therapy Vs. Intralesional Antimonials for Cutaneous Leishmaniasis in India. Br J Dermatol. 2013;168(5):1114-9. PubMed PMID: 23298394.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term efficacy of single-dose radiofrequency-induced heat therapy vs. intralesional antimonials for cutaneous leishmaniasis in India. AU - Bumb,R A, AU - Prasad,N, AU - Khandelwal,K, AU - Aara,N, AU - Mehta,R D, AU - Ghiya,B C, AU - Salotra,P, AU - Wei,L, AU - Peters,S, AU - Satoskar,A R, PY - 2013/1/10/entrez PY - 2013/1/10/pubmed PY - 2013/11/14/medline SP - 1114 EP - 9 JF - The British journal of dermatology JO - Br J Dermatol VL - 168 IS - 5 N2 - BACKGROUND: Radiofrequency-induced heat therapy (RFHT) has been found to be safe and effective against cutaneous leishmaniasis (CL) in the short term, but its long-term efficacy is unclear. OBJECTIVES: To compare the long-term efficacy of RFHT vs. intralesional sodium stibogluconate (SSG) injections in the treatment of CL in India. METHODS: One hundred patients with a confirmed diagnosis of CL were randomly assigned in a 1 : 1 ratio to receive topical RFHT for 30-60 s or seven intralesional injections of SSG (50 mg cm(-2) of lesion). Improvement and recurrence were monitored every 15 days after the initiation of treatment for 4 months and then at 5, 6, 9, 12 and 18 months post-treatment; the rates of complete cure were compared. RESULTS: Lesions were healed in 47 out of 50 patients (94%) in the RFHT group and in 46 out of 50 patients (92%) in the SSG group at week 12. Time to complete healing was comparable in the two groups. At 6 months post-treatment, cure rates in the RFHT and SSG groups were 98% [95% confidence interval (CI) 94-100%] and 94% (95% CI 86-100%), respectively. Age, sex and lesion size or number had no effect on cure rates. No relapse of infection was recorded in cured patients in either group up to 12-18 months after initiation of treatment. Skin biopsies of cured lesions in eight out of eight (100%) patients from the RFHT group and three of three from the SSG group at 12 months showed minimal fibrosis and were negative for Leishmania tropica by polymerase chain reaction test. CONCLUSIONS: A single application of RFHT is safe, cosmetically acceptable and effective in inducing a long-term cure of CL. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/23298394/Long_term_efficacy_of_single_dose_radiofrequency_induced_heat_therapy_vs__intralesional_antimonials_for_cutaneous_leishmaniasis_in_India_ L2 - https://doi.org/10.1111/bjd.12205 DB - PRIME DP - Unbound Medicine ER -