Efficacy of Fractional Wave CO 2 Laser10600nm For Treating Cutaneous Leishmaniasis

Abstract

Leishmaniasis, a truly ancient disease, was named after W.B.Leishman who identified organisms in smears taken from the spleen of a patient who died from Dumdum fever in 1901. Cutaneous Leishmaniasis constitutes 50 percent to 75 percent of all incident cases, and is the mildest form of the disease. It can be caused by any Leishmania sp. Most cases heal spontaneously within 1 year or more. Treatment : Given the clinical diversity of Leishmaniasis and the lack of adequately controlled therapeutic trials; each case needs to be individualized base. In spite of the fact that Cutaneous Leishmaniasis is ancient disease. Still the treatment is challenging. Recently C02 laser open new dimension for cure. objective: The study aim to determine the efficacy and safety of carbon dioxide laser in treatment of Cutaneous Leishmaniasis Methodology: This is prospective study ,carried out in Sudan University for Science and Technology from February to September 2014. The diagnosis of Cutaneous Leishmaniasis was done by clinical examination confirmed by smear. Then lesions were anesthetized by local anesthesia and treated by fractional C02 laser (between 10-15 watt, fractional wave duty time 500, idle time 0.005s, space 0.2mm, graphic circle and diameter depend on the lesion size). and the lesion covered by topical antibiotic. Result: There were 10 patients with 13 lesions, all treated with one session of C02 laser. Three lesions were 2 cm2 or less healed within 4 weeks with primary intension. Two lesions were 2-5 cm ' healed with scar with reduction in their original size ( ulcer). Eight lesions of 5 cm'' and more healed with scar with post inflammatory hyper pigmentation. At 12 week there was no evidence of recurrence .There was mild pain, and no major side effect. All patients felt it was satisfactory result. Conclusion: Carbon Dioxide laser is effective treatment for Cutaneous Leishmaniasis. Safe and simple.