COMPARATIVE EFFICACY OF LOW DOSE ORAL DAPSONE AND INTRALESIONAL MEGLUMINE ANTIMONIATE WITH INTRALESIONAL MEGLUMINE ANTIMONIATE IN THE TREATMENT OF PATIENTS WITH CUTANEOUS LEISHMANIASIS

Abstract

Objective: To assess the effectiveness of intralesional meglumine antimoniate and  low dose oral dapsone with intralesional meglumine antimoniate in treating individuals with cutaneous leishmaniasis

Study design: Randomized Control Trial

Place and duration of study: Dermatology Department, Chandka Medical College CMC, Larkana (November 2024 to April 2025).

Methodology: Sixty patients with cutaneous leishmaniasis participated in this six-month trial conducted in the dermatology department at CMC, Larkana. The lottery approach was used to randomly split the patients into two groups. Weekly intralesional meglumine antimoniate was administered to Group-A ( 1-2 ml of meglumine antimoniate have 405/5ml active antimony injected into every lesion depending on size) while Group-B got weekly intralesional meglumine antimoniate together with a low dose of oral dapsone ( 1-2 ml of meglumine antimoniate have 405/5ml with dapsone 25 mg initially for 1 week, it was then increased to 50 mg ) Participants received treatment for 16 weeks or until full clinical remission whichever came first. They were assessed for effectiveness at weeks four, eight, twelve, and sixteen of the therapy. If a patient in either group had full response—that is, full re-epithelialization, settling down of erythema, induration and scaling/crusting with residual post inflammatory hypo or hyperpigmentation, as determined by a clinical examination and photographic record, the treatment was considered effective. Data was analyzed by using SPSS statistical package version 26 software. Quantitative variables were reported through mean + standard deviation, whereas, frequencies and percentages were calculated for categorical variables. Chi-square test was applied to compare the efficacy between the two groups. P-value < 0.05 was taken as significant.

Results: Sixty patients were included in this study i-e 30 in each group. The mean age in Group-A was 30.17 + 6.30 years and in Group-B, it was 30.83 + 5.55 years. In both groups, most of the patients were male i.e. 86.6% in group-A and 83.3% in group-B. The two groups were not significantly different in terms of age, gender, size, site and type of lesion. Excellent response found in Combined group i-e Intralesional meglumine antimoniate with low dose oral dapsone was found to be higher (76.6%) than Intralesional Meglumine Antimoniate alone Group  (p = 0.000), with 16 weeks ’ treatment.

Conclusion: Combination treatment with low dose oral dapsone and intralesional meglumine antimoniate was more effective in treating cutaneous leishmaniasis.