Efficacy of Ketoconazole in Post—kala-azar Dermal Leishmaniasis

To the Editor.—  The drugs effective in post-kala-azar dermal leishmaniasis (PKDL) include parenteral administration of sodium antimony gluconate, amphotericin B, or pentamidine, of which sodium antimony gluconate is the treatment of choice.¹ The problem of giving a dose as high as 8.5 to 10 mL daily for the recommended period of 4 months is not only that the patient needs supervision but that it is difficult for the patient to endure. In an effort to find a suitable orally administered drug, we decided to assess the efficacy of ketoconazole (Nizoral tablets [200mgl, Janssen Pharmaceutica, Bombay, India) in PKDL, as this drug has recently proved useful in visceral leishmaniasis.²

Subjects, Methods, and Results.—  Four male patients with PKDL between 20 and 25 years of age were admitted into the study after obtaining their consent. The duration of the skin lesions varied from 2 to 4 years. Cutaneous examination