Single lesion cutaneous leishmaniasis in children - an effective, simple home based treatment :a preliminary report

Cutaneous leishmaniasis is an established vector borne disease in Sri Lanka. The use of different treatment modalities indicates lack of an effective monotherapy. The available treatment options are either painful, expensive or both.

Heat therapy has been used as an effective method of treatment for cutaneous leishmaniasis since 1950a. This is based on the fact that optimum temperature of the parasite is around 26"C15. Different heat delivery mechanisms have been practiced in the past. The device currently used is the Thermomade.

We have encountered a number of practical difficulties in carrying out current treatment in children. This study aims to determine efficacy of a novel, simple, house-hold method of local heat therapy in treating single lesion cutaneous leishmaniasis.

A total of 19 smear positive patients were included in the study. However, only 15 were enrolled as 4 patients were lost to follow up. AIl patients were treated at home by a trained parent. Treating included the method of heat delivery using a metal spoon. Clinical improvement was assessed using digital photographs by principal investigator. Efficacy of intervention was assessed by using a simple scoring system. A repeat smear was performed when necessary.

Twelve patients out of 15 had a dramatic response, achieving complete clinical clearance within two months of initiation of therapy and had no recurrence 5 months later. Another two responded to 6 months therapy and recurrence was not noted in subsequent follow up.