Efficacy of cryotherapy plus topical Juniperus excelsa M. Bieb cream versus cryotherapy plus placebo in the treatment of Old World cutaneous leishmaniasis: A triple-blind randomized controlled clinical trial.

Cutaneous leishmaniasis is one of the highly prevalent endemic diseases in the Middle East and North Africa. Many treatment modalities have been recommended for this condition but success rates remain limited. Herbal remedies have also been used for treatment but evidence-based clinical trials with...

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Main Authors: Mohammad Mahdi Parvizi, Farhad Handjani, Mahmoodreza Moein, Gholamreza Hatam, Majid Nimrouzi, Jafar Hassanzadeh, Nasrin Hamidizadeh, Hamid Reza Khorrami, Mohammad Mehdi Zarshenas
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-10-01
Series:PLoS Neglected Tropical Diseases
Online Access:http://europepmc.org/articles/PMC5655399?pdf=render
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author Mohammad Mahdi Parvizi
Farhad Handjani
Mahmoodreza Moein
Gholamreza Hatam
Majid Nimrouzi
Jafar Hassanzadeh
Nasrin Hamidizadeh
Hamid Reza Khorrami
Mohammad Mehdi Zarshenas
author_facet Mohammad Mahdi Parvizi
Farhad Handjani
Mahmoodreza Moein
Gholamreza Hatam
Majid Nimrouzi
Jafar Hassanzadeh
Nasrin Hamidizadeh
Hamid Reza Khorrami
Mohammad Mehdi Zarshenas
author_sort Mohammad Mahdi Parvizi
collection DOAJ
description Cutaneous leishmaniasis is one of the highly prevalent endemic diseases in the Middle East and North Africa. Many treatment modalities have been recommended for this condition but success rates remain limited. Herbal remedies have also been used for treatment but evidence-based clinical trials with these products are sparse. In-vitro and in-vivo studies have shown the anti-leishmanial and curative effects of extract of fruits and leaves of Juniperus excelsa (J. excelsa). The aim of this study was to determine the efficacy of topical J. excelsa M. Bieb extract as an adjuvant to cryotherapy for the treatment of human CL.This study was designed as a two-arm triple-blind randomized placebo-controlled clinical trial using a parallel design. Seventy-two patients with clinical diagnosis of CL confirmed by leishmania smears were allocated to receive either a topical formulation of leaf of J. excelsa extract (group A) or placebo (group B) for 3 months. Both groups received cryotherapy as baseline standard treatment. Patients were evaluated before and weekly after the intervention was initiated until complete cure.Overall, 82% of patients in group A, experienced complete cure and 9% of them had partial cure. On the other hand, 34% in group B reported complete cure, while 14% of them had partial cure at the end of treatment protocol with a significant difference between the two groups (P< 0.001). The mean duration to healing of the lesions in patients who received J. excelsa extract was statistically significantly shorter than the placebo group (p = 0.04). No significant side effect was seen in the J. excelsa extract group except for mild to moderate local irritation after a few weeks in a few numbers of patients.The results of this study showed that topical J. excelsa extract can be used as an adjuvant treatment modality in addition to cryotherapy for accelerating the time to cure in addition to increasing the complete cure rate in CL.ClinicalTrials.gov IRCT2015082523753N1.
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spelling doaj.art-279985116c714863b7b3cbf8f1c716ab2022-12-22T00:33:04ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352017-10-011110e000595710.1371/journal.pntd.0005957Efficacy of cryotherapy plus topical Juniperus excelsa M. Bieb cream versus cryotherapy plus placebo in the treatment of Old World cutaneous leishmaniasis: A triple-blind randomized controlled clinical trial.Mohammad Mahdi ParviziFarhad HandjaniMahmoodreza MoeinGholamreza HatamMajid NimrouziJafar HassanzadehNasrin HamidizadehHamid Reza KhorramiMohammad Mehdi ZarshenasCutaneous leishmaniasis is one of the highly prevalent endemic diseases in the Middle East and North Africa. Many treatment modalities have been recommended for this condition but success rates remain limited. Herbal remedies have also been used for treatment but evidence-based clinical trials with these products are sparse. In-vitro and in-vivo studies have shown the anti-leishmanial and curative effects of extract of fruits and leaves of Juniperus excelsa (J. excelsa). The aim of this study was to determine the efficacy of topical J. excelsa M. Bieb extract as an adjuvant to cryotherapy for the treatment of human CL.This study was designed as a two-arm triple-blind randomized placebo-controlled clinical trial using a parallel design. Seventy-two patients with clinical diagnosis of CL confirmed by leishmania smears were allocated to receive either a topical formulation of leaf of J. excelsa extract (group A) or placebo (group B) for 3 months. Both groups received cryotherapy as baseline standard treatment. Patients were evaluated before and weekly after the intervention was initiated until complete cure.Overall, 82% of patients in group A, experienced complete cure and 9% of them had partial cure. On the other hand, 34% in group B reported complete cure, while 14% of them had partial cure at the end of treatment protocol with a significant difference between the two groups (P< 0.001). The mean duration to healing of the lesions in patients who received J. excelsa extract was statistically significantly shorter than the placebo group (p = 0.04). No significant side effect was seen in the J. excelsa extract group except for mild to moderate local irritation after a few weeks in a few numbers of patients.The results of this study showed that topical J. excelsa extract can be used as an adjuvant treatment modality in addition to cryotherapy for accelerating the time to cure in addition to increasing the complete cure rate in CL.ClinicalTrials.gov IRCT2015082523753N1.http://europepmc.org/articles/PMC5655399?pdf=render
spellingShingle Mohammad Mahdi Parvizi
Farhad Handjani
Mahmoodreza Moein
Gholamreza Hatam
Majid Nimrouzi
Jafar Hassanzadeh
Nasrin Hamidizadeh
Hamid Reza Khorrami
Mohammad Mehdi Zarshenas
Efficacy of cryotherapy plus topical Juniperus excelsa M. Bieb cream versus cryotherapy plus placebo in the treatment of Old World cutaneous leishmaniasis: A triple-blind randomized controlled clinical trial.
PLoS Neglected Tropical Diseases
title Efficacy of cryotherapy plus topical Juniperus excelsa M. Bieb cream versus cryotherapy plus placebo in the treatment of Old World cutaneous leishmaniasis: A triple-blind randomized controlled clinical trial.
title_full Efficacy of cryotherapy plus topical Juniperus excelsa M. Bieb cream versus cryotherapy plus placebo in the treatment of Old World cutaneous leishmaniasis: A triple-blind randomized controlled clinical trial.
title_fullStr Efficacy of cryotherapy plus topical Juniperus excelsa M. Bieb cream versus cryotherapy plus placebo in the treatment of Old World cutaneous leishmaniasis: A triple-blind randomized controlled clinical trial.
title_full_unstemmed Efficacy of cryotherapy plus topical Juniperus excelsa M. Bieb cream versus cryotherapy plus placebo in the treatment of Old World cutaneous leishmaniasis: A triple-blind randomized controlled clinical trial.
title_short Efficacy of cryotherapy plus topical Juniperus excelsa M. Bieb cream versus cryotherapy plus placebo in the treatment of Old World cutaneous leishmaniasis: A triple-blind randomized controlled clinical trial.
title_sort efficacy of cryotherapy plus topical juniperus excelsa m bieb cream versus cryotherapy plus placebo in the treatment of old world cutaneous leishmaniasis a triple blind randomized controlled clinical trial
url http://europepmc.org/articles/PMC5655399?pdf=render
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