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SHORT COMMUNICATION
Year : 1993  |  Volume : 59  |  Issue : 3  |  Page : 120-121

Role of ketoconazole in oriental sore




Correspondence Address:
K K Singh


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Source of Support: None, Conflict of Interest: None


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  Abstract 

Thirty patients of oriental sore had received ketoconazole as treatment. The dose was 400 mg/day in divided doses. The duration of treatment ranged from 14 to 40 days with the mean of 31.6 days. Twenty eight patients (93.33%) had shown complete healing. Two patients (6.66%) did not show response. Ulcerative variety had complete response in all cases, whereas nodular variety had the same in 10 (83.33%) cases.


Keywords: Oriental sore, Ketoconazole


How to cite this article:
Singh K K, Kumar S, Singh V B, Mohan L, Mukhij. Role of ketoconazole in oriental sore. Indian J Dermatol Venereol Leprol 1993;59:120-1

How to cite this URL:
Singh K K, Kumar S, Singh V B, Mohan L, Mukhij. Role of ketoconazole in oriental sore. Indian J Dermatol Venereol Leprol [serial online] 1993 [cited 2020 Jun 1];59:120-1. Available from: http://www.ijdvl.com/text.asp?1993/59/3/120/3903



  Introduction Top


Oriental sore (cutaneous leishmaniasis, Delhi boil) is a chronic progressive granulomatous disease caused by Leishmania tropica which is transmitted through sandflies (commonly Phlebotomus papatassi). The disease commonly occurs in warm countries. It has a relatively long incubation period i.e., 2 weeks to more than a year. It heals with ugly scarring, if remains untreated.

Three distinctive forms, wet, dry and chronic lupoid have been described. Antimonials like Glucantime (meglumine antimonate) and Stibanate (sodium stibogluconate) are used intramuscularly or intravenously as the treatment. [1]

Recently dapsone [2] and ketoconazole [3] have been tried successfully. In the present series, an attempt has been made to assess the role of ketoconazole in oriental sore.


  Materials and Methods Top


Thirty patients of oriental sore had undergone therapeutic trial with ketoconazole. Diagnosis of each and every case was established by smear examination for LD (Leishmania Donovani) bodies. Liver function tests were found normal in all cases before giving ketoconazole. The study comprised of age group ranging from 2 years to 45 years and of both sexes (M:F=1.3:1). Children below 2 years and pregnant women were excluded from the study. Ketoconazole was given 400 mg per day in divided doses. The treatment was stopped and patients were declared cured following LD bodies negativity.

Ten cases of oriental sore were also assessed as controls.


  Results Top


Out of 30 cases of oriental sore, 29 (93.33%) had shown complete healing, whereas no noticeable response was observed in 2(6.66%) cases. The duration of treatment ranged from 14 to 40 days, with the mean of 31.6 days.

The details of response of ketoconazole in 2 varieties are given in brief in [Table - 1]. The only side effect of ketoconazole observed was the jaundice in 1 patient but improvement in the same patient was remarkable following cessation of ketoconazole therapy.


  Comments Top


Ketoconazole, an imidazole derivative is effective against most of the fungi and yeast. It has also been used successfully in the treatment of leishmaniasis earlier [3],[4] Ketoconazole has been shown to possess antileishmanial activity in human macrophage cultures infected with parasites. Leishmania contain large amounts of ergosterol and ketoconazole probably acts against these protozoa by interfering with ergosterol synthesis. [4] The inhibition of ergosterol synthesis is due in part to the ability of the ketoconazole to inhibit demethylation of lanosterol, a precursor of ergosterol. [5]

 
  References Top

1.Harman RRM. Oriental sore. In : Textbook of Dermatology (Rook A, Wilkinson DS, Ebling FJG, Champion RH, Burton JL, eds), 4th edn. Oxford : Blackwell Scientific, 1936; 1021-2.  Back to cited text no. 1    
2.Dogra J, Lal BB, Misra SN. Dapsone in the treatment of cutaneous leishmaniasis. Int J Dermatol 1986; 25:398-400.  Back to cited text no. 2  [PUBMED]  
3.Rakel RE. Conn's Current Therapy (Rakel RE ed). Philadelphia : WB Saunders, 1989; 68.  Back to cited text no. 3    
4.Seetharam KA, Pasricha JS. Ketoconazole in Dermatology. Ind J Dermatol Venereol Leprol 1988; 54: 67-74.  Back to cited text no. 4    
5.Morle AS, Mandell GL. Antimicrobial acents. In : The Pharmacological Basis of Therapeutics (Gilman AG, Goodman LS, Rall TW, et al. eds), 7th edn. New York Macmilan, 1985; 1226.  Back to cited text no. 5    


    Tables

[Table - 1]



 

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