{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T06:18:53Z","timestamp":1773901133319,"version":"3.50.1"},"reference-count":21,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,11,8]]},"abstract":"<jats:p>Meglumine Antimoniate (MA), administered intramuscularly for 21 continuous days is the recommended treatment of leishmaniases in Ecuador. However, because of its toxicity and requirement for intramuscular injections, treatment is frequently abandoned before completion. In addition, therapeutic failure and reactivation are not uncommon. Here we evaluate the efficacy and safety of MA administered intralesionally (IL) in leishmaniasis recidiva cutis (LRC). LRC is a special clinical variant of cutaneous leishmaniasis, characterized by reactivation at the edges of a primary cured lesion, presenting with active papules around the scar. Twenty-one patients were included in the study. All were diagnosed parasitologically by one of three diagnostic methods (smear, culture, and Leishmanin skin test). Each patient received MA intralesionally weekly for 4 weeks. Each papule was infiltrated until complete saturation. On average, patients received 1 mL of MA per administration. The criterion of cure was the complete resolution of the papules. Follow up was performed at 30, 90, and 180 days after treatment. At day 30 after treatment, 19 (90.5%) of 21 patients were clinically cured. The two patients, who did not heal by the fourth application, were cured on the seventh and eighth dose, achieving a clinical cure of 100% without subsequent reactivation. Mild to moderate local pain during infiltration was the only adverse reaction experienced by 81% of patients. In one case, subsequent infiltrations were discontinued because of a local allergic reaction. Complete compliance of patients to treatment and the small volume of drug administered make this method of administering MA an effective, safe, and inexpensive alternative. Consequently, IL could replace intramuscular administration in the treatment of LRC in Ecuador.<\/jats:p>","DOI":"10.4269\/ajtmh.17-0340","type":"journal-article","created":{"date-parts":[[2017,9,6]],"date-time":"2017-09-06T07:00:29Z","timestamp":1504681229000},"page":"1508-1512","source":"Crossref","is-referenced-by-count":7,"title":["Intralesional Infiltration with Meglumine Antimoniate for the Treatment of Leishmaniasis Recidiva Cutis in Ecuador"],"prefix":"10.4269","volume":"97","author":[{"given":"Manuel","family":"Calvopi\u00f1a","sequence":"first","affiliation":[{"name":"Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad De Las Am\u00e9ricas (UDLA), Quito, Ecuador;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Cevallos","sequence":"additional","affiliation":[{"name":"Carrera de Medicina, Facultad de Ciencias M\u00e9dicas, Universidad Central del Ecuador, Quito, Ecuador;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yolanda","family":"Paredes","sequence":"additional","affiliation":[{"name":"Laboratorio de Patolog\u00eda Cl\u00ednica, Carrera de Laboratorio Cl\u00ednico, Universidad Central del Ecuador, Quito, Ecuador;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edison","family":"Puebla","sequence":"additional","affiliation":[{"name":"Carrera de Medicina, Facultad de Ciencias M\u00e9dicas, Universidad Central del Ecuador, Quito, Ecuador;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Flores","sequence":"additional","affiliation":[{"name":"Carrera de Medicina, Facultad de Ciencias M\u00e9dicas, Universidad Central del Ecuador, Quito, Ecuador;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Loor","sequence":"additional","affiliation":[{"name":"Carrera de Medicina, Facultad de Ciencias M\u00e9dicas, Universidad Central del Ecuador, Quito, Ecuador;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Padilla","sequence":"additional","affiliation":[{"name":"Epidemiolog\u00eda, Distrito de Salud 17 D-12, Ministerio de Salud P\u00fablica del Ecuador, Quito, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","author":"Word Health Organization (WHO)","year":"2010"},{"key":"b2","series-title":"PLoS Negl Trop Dis","first-page":"e2130","article-title":"Methodology of clinical trials aimed at assessing interventions for cutaneous leishmaniasis","volume":"7","author":"Olliaro","year":"2013"},{"key":"b3","series-title":"Acta Trop","first-page":"153","article-title":"Comparison of the effectiveness of two topical paromomycin treatments versus meglumine antimoniate for new world cutaneous leishmaniasis","volume":"91","author":"Armijos","year":"2004"},{"key":"b4","first-page":"1","author":"Organizaci\u00f3n Panamericana de la Salud (OPS)","year":"2013"},{"key":"b5","series-title":"Mem Inst Oswaldo Cruz","first-page":"663","article-title":"Epidemiology of leishmaniasis in Ecuador: current status of knowledge\u2014a review","volume":"99","author":"Calvopina","year":"2004"},{"key":"b6","series-title":"Rev Fac Cien Med (Quito)","first-page":"31","article-title":"Prevalencia y formas cl\u00ednicas de las leishmaniasis en el noroccidente de la provincia de Pichincha \u2013 Ecuador","volume":"37","author":"Calvopina","year":"2012"},{"key":"b7","series-title":"Am J Trop Med Hyg","first-page":"281","article-title":"Atypical clinical variants in new world cutaneous leishmaniasis: disseminated, erysipeloid, and recidiva cutis due to Leishmania (V.) panamensis","volume":"73","author":"Calvopina","year":"2005"},{"key":"b8","series-title":"Trop Med Health","first-page":"93","article-title":"Leishmaniasis recidiva cutis and its topical treatment in Ecuador","volume":"41","author":"Calvopina","year":"2013"},{"key":"b9","series-title":"Int J Dermatol","first-page":"116","article-title":"Leishmaniasis recidiva cutis due to Leishmania (Viannia) panamensis in subtropical Ecuador: isoenzymatic characterization","volume":"45","author":"Calvopina","year":"2006"},{"key":"b10","series-title":"BMC Infect Dis","first-page":"e139","article-title":"Leishmania isoenzyme polymorphisms in Ecuador: relationships with geographic distribution and clinical presentation","volume":"6","author":"Calvopina","year":"2006"},{"key":"b11","series-title":"PLoS Negl Trop Dis","first-page":"e0004844","article-title":"Geographic distribution of Leishmania species in Ecuador based on the Cytochrome B gene sequence analysis","volume":"10","author":"Kato","year":"2016"},{"key":"b12","series-title":"Am J Trop Med Hyg","first-page":"92","article-title":"Placebo controlled treatment of Ecuadorian cutaneous leishmaniasis","volume":"45","author":"Guderian","year":"1991"},{"key":"b13","series-title":"Am J Trop Med Hyg","first-page":"195","article-title":"Cutaneous leishmaniasis \u201cChiclero\u2019s Ulcer\u201d in subtropical Ecuador","volume":"89","author":"Calvopina","year":"2013"},{"key":"b14","series-title":"Trop Med Int Health","first-page":"140","article-title":"The epidemiology of cutaneous leishmaniasis in subtropical Ecuador","volume":"2","author":"Armijos","year":"1997"},{"key":"b15","series-title":"Clin Infect Dis","first-page":"1255","article-title":"Intralesional antimony for single lesions of Bolivian cutaneous leishmaniasis","volume":"56","author":"Soto","year":"2013"},{"key":"b16","series-title":"Am J Trop Med Hyg","first-page":"852","article-title":"Intralesional pentamidine: a novel therapy for single lesions of Bolivian cutaneous leishmaniasis","volume":"94","author":"Soto","year":"2016"},{"key":"b17","series-title":"Int J Dermatol","first-page":"463","article-title":"Intralesional therapy of American cutaneous leishmaniasis with pentavalent antimony in Rio de Janeiro, Brazilian area of Leishmania (V.) braziliensis transmission","volume":"36","author":"Oliveira-Neto","year":"1997"},{"key":"b18","series-title":"Am J Trop Med Hyg","first-page":"257","article-title":"Intralesional meglumine antimoniate for treatment of cutaneous leishmaniasis patients with contraindication to systemic therapy from Rio de Janeiro (2000 to 2006)","volume":"87","author":"Vasconcellos","year":"2012"},{"key":"b19","series-title":"Mem Inst Oswaldo Cruz","first-page":"512","article-title":"Intralesional meglumine antimoniate for the treatment of localised cutaneous leishmaniasis: a retrospective review of a Brazilian referral centre","volume":"111","author":"Silva","year":"2016"},{"key":"b20","year":"2007"},{"key":"b21","series-title":"Rev Inst Med Trop Sao Paulo","first-page":"361","article-title":"Resolution of cutaneous leishmaniasis after acute eczema due to intralesional meglumine antimoniate","volume":"56","author":"Ferreira-Vasconcellos","year":"2014"}],"container-title":["The American Journal of Tropical Medicine and 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