**13. Intralesional antimonial therapy**

Sodium stibogluconate (100 mg antimony/ml) or meglumine antimoniate is injected into all sides of the lesion until it blanches on alternate days. A total of 10 injections is given. This treatment is combined with cryotherapy for better results [16]

**Other local therapy options:** Surgical excision, curettage, laser ablation, photodynamic therapy, sodium chloride (moist wound therapy), topical azoles, topical glyceryl trinitrate, topical amphotericin B, intralesional interferon-gamma and intralesional metronidazole [17].

## **14. Assessing response to treatment**

Clinical symptoms will take time to improve in cutaneous leishmaniasis. Time taken vary from patient to patient. After effective treatment, it takes around 4 to 6 weeks for the ulcer to show signs of healing, which includes re-epithelialization, reduction in the size of the ulcer, reduction of signs of local inflammation. Healing continues till 12 weeks' time, at which decisions about continued observation versus retreatment should be made. Because of the chances of relapse in cutaneous leishmaniasis, complete responses are not measured until 6 to 12 months after successful therapy.
