{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:11:46Z","timestamp":1788855106063,"version":"build-2803163510"},"reference-count":62,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cutaneous leishmaniasis (CL) is increasingly reported in previously non\u2010endemic European countries. Although often self\u2010limiting or amenable to topical therapy, systemic treatment is indicated in specific situations. Evidence guiding systemic therapies remains limited and heterogeneous.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis aimed to synthesize available evidence on systemic treatment regimens for CL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      MEDLINE\/PubMed and Embase were searched for clinically and\/or parasitologically confirmed CL receiving systemic monotherapy with meglumine antimoniate (MA), miltefosine, azoles, pentamidine, or liposomal amphotericin B (L\u2010AmB) until February 2026. Primary outcome was clinical cure assessed 2\u20137.5\u2009months after treatment initiation. Pooled cure rates were estimated using random\u2010effects meta\u2010analysis. Subgroup analyses were performed for Old World (OWCL) and New World (NWCL) CL, and by\n                      <jats:italic>Leishmania<\/jats:italic>\n                      species.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighty\u2010three studies comprising 96 treatment arms and 4603 patients with OWCL and NWCL were included. Overall, study quality was moderate (per JBI checklist). MA, long regarded as standard of care in many countries, had a pooled cure rate of 59% (95% CI 52%\u201366%). Higher rates were observed with L\u2010AmB (77%; 95% CI 56%\u201390%), followed by miltefosine (75%; 95% CI 69%\u201381%), itraconazole (70%; 95% CI 65%\u201376%), and fluconazole (62%; 95% CI 16%\u201393%). Lower rates were obtained with pentamidine (55%; 95% CI 42%\u201367%) and ketoconazole (36%; 95% CI 7%\u201382%). Species\u2010 and region\u2010specific sub\u2010analyses indicated miltefosine highly effective for OWCL (particularly\n                      <jats:italic>L. major<\/jats:italic>\n                      ) and NWCL (\n                      <jats:italic>L. braziliensis<\/jats:italic>\n                      ,\n                      <jats:italic>L. guyanensis<\/jats:italic>\n                      ,\n                      <jats:italic>L. panamensis<\/jats:italic>\n                      ). Head\u2010to\u2010head comparisons of miltefosine and MA showed no statistically significant difference. L\u2010AmB was similarly effective in NWCL (particularly\n                      <jats:italic>L. braziliensis<\/jats:italic>\n                      ), with lack of evidence for other species.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Systemic treatment options for CL show variable efficacy. Despite the promising cure rates for miltefosine and L\u2010AmB, comparative evidence remains insufficient to support therapy recommendations. Confirmation in adequately powered, high\u2010quality RCTs, ideally stratified by species, is warranted to strengthen the evidence base.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdv.70711","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:03:20Z","timestamp":1788854600000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic treatment of cutaneous leishmaniasis: A systematic review and meta\u2010analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2097-1723","authenticated-orcid":false,"given":"Maximilian","family":"Egg","sequence":"first","affiliation":[{"name":"Department of Dermatology Medical University of Vienna  Vienna 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