Background. Topical treatment of cutaneous leishmaniasis is an attractive alternative avoiding toxicities of parenteral therapy while being administered through a simple painless route. Recently liposomal formulations of amphotericin B have been increasingly used in the treatment of several types of leishmaniasis. Aims. The efficacy of a topical liposomal amphotericin B formulation was compared with intralesional glucantime in the treatment of cutaneous leishmaniasis. Methods. From 110 patients, the randomly selected 50 received a topical liposomal formulation of amphotericin B into each lesion, 3–7 drops twice daily, according to the lesion's size and for 8 weeks. The other group of 60 patients received intralesional glucantime injection of 1-2？mL once a week for the same period. The clinical responses and side effects of both groups were evaluated weekly during the treatment course. Results. Per-protocol analysis showed no statistically significant difference between the two groups ( , 95% confidence interval (0.632–4.101)). Moreover, after intention-to-treat analysis, the same results were seen ( , 95% (0.560–2.530)). Serious post treatment side effects were not observed in either group. Conclusions. Topical liposomal amphotericin B has the same efficacy as intralesional glucantime in the treatment of cutaneous leishmaniasis. 1. Introduction Leishmaniasis is a major world health problem, which is increasing in incidence. The diagnosis is often made on the basis of a clinically typical lesion in conjunction with an appropriate history of exposure [1]. Although cutaneous leishmaniasis (CL) is a spontaneously resolving disease usually within a year, the resulting disfigurement and the duration of the disease require an effective treatment [2]. A wide range of therapeutic options have been employed over the years but its optimal treatment is not yet known whereas drug resistance is becoming an increasing problem in countries of leishmaniasis endemicity [3]. Amphotericin B (AmB), a polyene antibiotic and the gold standard for systemic fungal infections, also has excellent antileishmanial activity. Due to the higher affinity of AmB for 24-substituted sterols, aqueous pores are formed in the membrane leading to increased membrane permeability and killing of Leishmania [4]. It is commonly administered intravenously as an alternative treatment in visceral and mucocutaneous leishmaniasis [5–7]. In a mouse model it has been shown that topical AmB as a complex either with cholesteryl sulfate or with phospholipids in the presence of ethanol can penetrate into the
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