Background: Cutaneous Leishmaniasis (CL) is an endemic disease in many countries and caused by different species of Leishmania parasite. It results in a deformed scar after a relatively long period. Many therapies have been tried in treatment of this disease. Objective: To compare the effect of oral zinc sulfate and oral ketoconazole singly and in combination in the treatment of acute cutaneous leishmaniasis. Patients and Methods: This single, blinded, therapeutic, controlled study was conducted in the Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq, during the period, January 2015 to July 2015. Seventy-five patients with acute CL were enrolled in this study. The total numbers of lesions were 327, and the duration of lesions ranged from 4 to 12 (6.9 ± 0.7) weeks. The diagnosis was confirmed by smear and histopathology. Patients were divided into three groups: 24 patients in Group A were treated with oral zinc sulfate capsules 10 mg/kg/day for 6 weeks; 24 patients in Group B were treated with ketoconazole tablets 200 mg twice daily for 6 weeks and 27 patients in Group C were treated orally with a combination of zinc sulfate and ketoconazole for 6 weeks. All patients were seen regularly every 2 weeks for 6 weeks of treatment period, then monthly for the next three months as follow up period. Healing of the lesions was assessed by using Sharquie's modified Leishmania score to assess the objective response to the topical or systemic therapy. Results：After six weeks, 75 patients have completed the treatment, 24patients received zinc sulfate capsule, 24 patients received oral ketoconazole and 27 patients received a combination of both treatments. The cure rate was (60%) in the group receiving oral zinc sulfate capsuleand (50%) in the one receiving oral ketoconazole tablet (P = 0.146) and (96%) in the combination group (P ˂ 0.04). Conclusion: The combination therapy using oral zinc sulfate and oral ketoconazole gave a high cure rate. The combination therapy is a new mode of therapy as both drugs act in a synergistic way.

Background: Zinc sulphate as intralesional and oral therapy was used as a successful therapy in treatment of cutaneous leishmaniasis while 25% topical podophyllin is now commonly used in the treatment of cutaneous leishmaniasis. Objective: To treat acute cutaneous leishmaniasis using topical zinc sulphate solution 25% to be compared with topical podophyllin solution 25%.Patients and Methods: This is a single, blind, interventional, comparative study done in the Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq during the period from January 2015 to June 2015. Forty patients with a total 88 lesions of acute cutaneous leishmaniasis were enrolled in this study; 54 (61.36%) were dry lesions and 34 (38.6%) were ulcerative type. The duration of lesions ranged from 2 -11 (7.7 + 2.483) weeks. The size of the lesions ranged from 0.3 to 8 (2.13 ± 1.53) cm. There were 21 females and 19 males, female to male ratio (1.1:1) and their ages ranged from 1 to 60 (25.92 ± 16.59) years. Diagnosis was confirmed by tissue smear and histopathology. Lesions were divided into two groups with matching types and sizes, and scored according to Sharquie modified Leishmania score to assess the objective response to the topical or systemic therapy and then during follow up responses were graded into mild, moderate, marked response and complete clearance. Group A treated with topical 25% podophyllin solution once weekly for a maximum of 6 weeks, while group B was treated with topical 25% zinc sulphate solution twice daily for 6 weeks. Follow up was every 2 weeks during therapy, and once monthly for 3 months after therapy. Results: A total of 40 patients with clinical diagnosis of acute cutaneous leishmaniasis were included in this study, with a total of 88 lesions. Fifteen (37.50%) patients had Conclusion: Topical zinc sulphate 25% is an effective simple non-invasive non-costly safe topical therapy for cutaneous leishmaniasis and without any contraindications for its use and free of side effects and was as effective as topical podophyllin.

Background: Ketoconazole was introduced in 1981 as the first in a series of antifungal agents that are characterized by nitrogen-containing ring. Ketoconazole acts against many different kinds of fungi such as candida, dermatophytes and as pergillus. Also oral ketoconazole had proved its effectiveness in the treatment of cutaneous Leishmaniasis. Objective: To evaluate the safety of oral ketoconazole in the treatment of different skin diseases like cutaneous Leishmaniasis (CL), tineacapitis, tineacorporis and tineaversicolor. Patients and Methods: This is a single, blinded, therapeutic, controlled study that was carried out in the

Background: Cutaneous leishmaniasis (CL) is an endemic disease in Iraq, now is running in an outbreaks. Many therapies have been tried in treatment of the disease. Objective: Loranthus europaeus (LE) is a well-known medical plant and has many pharmacological effects in many in vitro studies. The aim of the study is to evaluate the effectiveness of 40% LE ointment and compared it with topical 25% podophyllin solution in treatment of acute CL. Patients and Methods: Thirty five patients with acute CL were enrolled in this single blinded, therapeutic, comparative study, which was done in the Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq during January 2015-Jully 2015. The total number of lesions were 86 (76 lesions treated and ten lesions in a covered area left without treatment as control). Duration of lesions ranged from 4 to 12 (7.37 ± 2.77) weeks. The size of lesions ranged from 0.5 -7 (2.81 ± 1.76) cm. Diagnosis was confirmed by biopsy and/or smears. Lesions were divided in to two groups and scored as (mild, moderate, marked, complete cure) according to a modified Sharquie's leishmania score to assess the objective response to the topical or systemic therapy. Group A: Thirty three (43.42%) lesions treated with topical 25% podophyllin solution once weekly for maximum 6 weeks. Group B: Forty three (56.58%) lesions treated with 40% LE ointment once daily at bedtime for 6 hours under occlusion for maximum 6 weeks. The followed-up was carried out every 2 weeks for 8 weeks during treatment, then monthly for next three months after end of therapy. Results: the total number of lesions was 86 lesions, 46 (53.49%) were ulcerated and 40 (46.51%) were dry; 18 (51.43%) patients had single lesion while 17 (48.57%) patients had multiple lesions. At the end of therapy (6 weeks after starting treatment), the cure rate was 84.84% in Group A, and 79.07% in Group B. When the two groups compared with each other there was no statistical significance difference were P value = 0.648. While untreated ten lesions that lefts as control did not showed any signs of healing. Conclusion: Topical 40% Loranthus europaeus ointment is a new effective modality for treatment of acute CL and as effective as 25% podophyllin solution with no any noticeable local or systemic side effects.