Treatment of Mucocutaneous leishmaniasis
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29.12.08
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Systemic drugs should be given. In South America meglumine antimonate® (20 mg Sb/kg/day for 30 days) is first choice. Beware: the dose is expressed in mg antimony (Sb). Alternatives are amphotericin B (Fungizone®), pentamidine and allopurinol. Ketoconazole can be used in L. mexicana infections. Plastic surgery is sometimes necessary in espundia in case of disfigurement. The use of pentoxyphylline (a xanthine derivative) plus antimony in refractory mucosal leishmaniasis is still in the experimental phase. Pentoxyphylline 400 mg t.i.d. orally for 30 days should have an anti-TNF-α effect. It is better known for its vasodilating effects (use in chronic occlusive diseases of the legs).
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