The response of a patient following therapy for cutaneous leishmaniasis can be evaluated based on the change in the lesions over the course of therapy. This can help separate patients who have good response from those who have been resistant to the regimen prescribed.
If more than 1 lesion is present, evaluation is based on the lesion that has shown least improvement.
Clinical cure: classical scar with disappearance of edema, induration and other inflammatory signs at the end of the therapeutic course.
Clinical improvement: significant reduction in the size of the lesion at the end of the therapeutic course.
Size of Lesion
Signs of Inflammation
Re-epithelialization
Score
decrease by < 50%
reduced
discrete
M1
decreased 50-90%
moderately reduced
more advanced
M2
decreased > 90%
little or none
complete
M3
decreased 100% (closed)
little or none
complete
M4
where:
• Signs of inflammation include erythema and edema.
Treatment failure: no improvement, with the lesion(s) active and unchanged or worsened as compared to the status at the initiation of therapy.
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