Intralesional D- penicillamine for treatment of acute cutaneous leishmaniasis

Background: : Cutaneous leishmaniasis (CL) described as ancient disease. caused by parasite hemoflagellate Leishmania, CL is widespread and may lead to serious health problems in the Mediterranean and Middle East, including Iraq. D-penicillamine(D-PA) does not have any antibiotic activity, so intralesional D-PA injection for treatment of CL may directly related to its property to enhancement Th1 immune response. Objective: : to evaluation the efficacy and safety of intralesional D-PA. Patients and method : All patients enrolled in study have two or more lesions that divided in two categories, Category A (penicillamine group): Intralesional (5%) D-PA was used as therapy. Category B (control group): No treatment was getting for patients in this group. Results: : A total of 49 patients with 144 lesions of acute CL have been enrolled in study. Category A: 95 lesions were treated, 87(91.15%) lesions showed cure, of which 69(72.6%) lesions have complete response and 18(18.9%) lesions have marked response after 3 to 6 sessions. The remaining 8(8.4%) patients showed moderate response after 6 sessions. Category B: controlled 49 lesions showed no sign of healing, apart from 5(10.2%) lesions became ulcerated at end of study. Conclusion: : Intralesional D- penicillamine is new, safe, affordable and effective treatment of CL.