Reworking the treatment of Indian Post kala-azar dermal leishmaniasis: A two-step therapy

In the current scenario, treatment of Post kala-azar dermal leishmaniasis (PKDL) is intravenous liposomal amphotericin B or oral miltefosine. Over the years, there has been a gradual decline in the efficacy of miltefosine and a rise in permanent loss of vision. Moreover, in non-endemic states of India, miltefosine is not freely available. In view of this, we attempted a two-step regimen of liposomal amphotericin B and itraconazole to treat two patients of PKDL diagnosed on histopathology as well as PCR. We found this treatment to be highly effective with complete recovery.