Ablative fractional laser resurfacing with topical paromomycin as adjunctive treatment for a recalcitrant cutaneous leishmaniasis wound

BACKGROUND AND OBJECTIVE: Leishmaniasis is a vector borne disease that can cause disease manifestations that range from localized skin ulceration to lethal visceral disease. With increased global travel, cutaneous leishmaniasis (CL) is becoming more common in developed nations. However, current treatment options are limited. STUDY DESIGN: We report a 16-year-old female who presented with several non-tender, non-healing CL wounds on her bilateral upper and lower extremities. Ablative fractional laser resurfacing (AFR) was used in conjunction with topical paromomycin via laser-assisted delivery to treat the largest non-healing CL wound on the patient's distal lower extremity. RESULTS: Upon follow-up after two treatments with AFR, the patient's wound healed completely without evidence of infection and with minimal scarring. CONCLUSION: AFR with laser-assisted delivery of topical paromomycin represents a novel treatment option for resistant, non-healing CL wounds. The technique may prove additionally useful for concurrent mitigation of scarring related to CL.