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Immunocompromised patient with an ulcerated nasolabial skin lesion

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c1444 (Published 31 March 2010) Cite this as: BMJ 2010;340:c1444

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Miltefosine for cutaneous Leishmaniasis

The traditional therapies for leishmaniasis involves
intramuscular administration sodium stiboglucante which
apart from being extremely painful, needs monitoring for
many side effects including transaminitis and dysrhythmias.
Side effects from amphotericin B are equally serious and the
liposomal preparations are extremely costly.

Given the fact that milefosine has been demonstrated to be
efficacious in therapy for cutaneous leishmaniasis and with
its oral route of administration and better side effect
profile, it is likely to emerge as a drug of choice for both
visceral and cutaneous leishmaniasis. However there have
been doubts regarding efficacy against some strains of L.
braziliensis while others have dissented with these results.
(1,2)

1. Soto J, Arana BA, Toledo J, Rizzo N, Vega JC, Diaz A, Luz
M, Gutierrez P,Arboleda M, Berman JD, Junge K, Engel J,
Sindermann H. Miltefosine for new world cutaneous
leishmaniasis. Clin Infect Dis 2004;38:1266-72.

2. oto J, Toledo JT. Oral miltefosine to treat new world
cutaneous leishmaniasis. Lancet Infect Dis 2007;7:7

Competing interests:
None declared

Competing interests: No competing interests

05 April 2010
Vishal Sharma
Senior Resident
University College of Medical Sciences, Delhi
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