Topical treatment with paromomycin for cutaneous leishmaniasis

Cutaneous leishmaniasis, especially on the face, continues to present a complex therapeutic problem because of the potential formation of ugly scars. We present a 6-year-old girl who recently immigrated to Israel from Ethiopia with extensive facial lesions of cutaneous leishmaniasis. Treatment with ketoconazole caused liver damage. Local application of an ointment containing paromomycin sulfate and methylbenzethonium chloride for 3 weeks resulted in complete recovery with minimal scarring.