Efficacy of local heat therapy by radiofrequency in the treatment of cutaneous leishmaniasis, compared with intralesional injection of meglumine antimoniate

Background. Cutaneous leishmaniasis ( CL) is a serious public health problem in many tropical and subtropical regions of the world. Treatment of CL can prevent disfiguring scars. Aim. The efficacy of local heat therapy by radiofrequency ( RF) was compared with intralesional injection of meglumine antimoniate in the treatment of CL. Methods. This was a randomized clinical trial. Patients with antroponotic cutaneous leishmaniasis ( ACL) in the Isfahan province of Iran were enrolled in the study if the examination of a smear from a suspected CL lesion was confirmed positive for Leishmania. Patients were randomly allocated to one of two treatment groups. Group A was treated by heat therapy by RF at 50 degrees C for 30 s once weekly for 4 weeks, and group B was treated with intralesional injection of meglumine antimoniate once weekly for 4 weeks. Follow-up lasted 6 months. Response to treatment was classified as complete ( lesions flattened, no induration, and epidermal creases had appeared), partial ( reduction in lesion size, but without the appearance of epidermal creases) and poor ( no reduction in lesion size). Results. Of 117 participants, 57 patients with 83 lesions in group A and 60 patients with 94 lesions in group B completed the study and were followed up for 6 months. Complete, partial and poor response to treatment were 80.7%, 12% and 7.3% in group A, and 55.3%, 21.27% and 23.40% in group B, respectively ( P = 0.001). In both groups, there was no relapse in patients with complete response after 6 months of follow-up. Conclusions. Heat therapy with thermogenerator RF can be used as an efficacious treatment in the lesions of CL. It is more effective than the conventional treatment with intralesional meglumine antimoniate injection.