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We appreciate Dr Long's comments and his sharing of his experience and expertise in the therapy of oriental sore.In our article we stated that "the best management of uncomplicated cases of acute cutaneous leishmaniasis (L tropica) may be to observe the patient and withhold treatment." Our recommendation was aimed at acute, uncomplicated cases only. The chronic forms of leishmaniasis seem to have clearer indications for therapy, and complications such as bacterial secondary infection clearly warrant appropriate treatment.Medical practitioners must always weigh the potential benefit of a course of therapy against potential harm. Pentavalent antimonial compounds remain potentially toxic drugs. Their proper use necessitates careful monitoring of the patient and specifically those organs known to be targets of these drugs. The cases of cutaneous leishmaniasis which we encountered ran a rather benign course, and there is little question in our minds that withholding therapy from these
Rau R, Dubin HV, Taylor WB. Leishmania tropica Infections-Reply. Arch Dermatol. 1977;113(1):108-109. doi:10.1001/archderm.1977.01640010110021