A double blind, randomised placebo controlled trial of rifampicin with omeprazole in the treatment of human cutaneous leishmaniasis.

BACKGROUND & OBJECTIVES: This study was conducted on 50 patients of Anthroponotic cutaneous leishmaniasis (oriental sore) to assess the efficacy of rifampicin and omeprazole through a double blind, randomised placebo control study. METHODS: The diagnosis of Anthroponotic cutaneous leishmaniasis (ACL) caused by Leishmania tropica was done by demonstration of Leishmania tropica (LT) bodies from the painless, dry ulcerative lesion. Each patient was assessed clinically in the beginning of the study, at the end of 2,4 and 6 weeks and all observations were compared in both the groups. Twenty-five patients received rifampicin with omeprazole (Group A) whereas other 25 patients received placebo (Group B) for a period of six weeks. RESULTS: Altogether 23 cases in group Aand 21 cases in group B completed the study. About 16 (69.7%) cases in group A and 3 (14.29%) cases in group B had complete healing, whereas 3 patients (13.04%) of group A and 4 patients (19.05%) of group B had partial response and 4 patients (17.93%) of group A and 14 patients (66.67%) of group B had no response at the end of study. The difference of two groups was statistically highly significant (p < 0.00025). All patients tolerated the drug and placebo very well and no side effect was reported. INTERPRETATION & CONCLUSION: In our opinion rifampicin and omeprazole is a highly effective, less toxic and cheaper alternative for the management of cutaneous leishmaniasis.

Amoebiasis cutis in HIV positive patient.

Protozoan infections of the skin, particularly cutaneous amoebiasis, are rare in HIV-positive patients. We report a case of amoebiasis cutis in an HIV-positive truck driver with a history of frequent unprotected sexual exposures. He presented with multiple painful ulcers and sinuses with purulent discharge, necrotic slough and scarring in the perianal and gluteal region for the last 2 years. He was positive for HIV-1 and -2. Cutaneous biopsy revealed numerous Entamoeba histolytica in the trophozoite form, in addition to an inflammatory infiltrate and necrotic debris. He responded well to oral metronidazole and chloroquine. Amoebiasis cutis should be considered in the differential diagnosis of perianal ulcers, particularly in HIV-positive patients.

Oral rifampicin in cases of cutaneous leishmaniasis with multiple lesions (a pilot study).

The multiple lesions of cutaneous leishmaniasis (CL) require an effective oral agent. We are reporting a pilot study of oral rifampicin 600 mg. bid or 20 mg/kg. body weight in cases of CL with multiple lesions. Our study shows 83.3% parasitological and clinical cure with insignificant side effects after 4 weeks of therapy. No relapse upto 6 months of completion of study was seen.

Dermatoglyphics in leprosy.

In the present study, dermatolyphic parameters were analysed in the handprints of 25 LL/BL, 25 TT/BT and 25 healthy persons, by printer's ink method. Frequency of loops, were more on right hand and whorls were more on left hand in LL patients as compared to normal healthy controls. In TT the whorls were less frequent than in controls. The a-b ridge count in LL patient has shown insignificant difference from control while the same in TT was significantly decreased (P less than 0.05). Distance between distal wrist crease and axial triradius was significantly decreased in LL as compared to normal (P less than 0.05), whereas no such decrease was observed in TT patients.