Heat Therapy treats soldiers in Iraq

Washington, Mar 10 : A parasitic skin infection spread by sand flies common in Iraq and Afghanistan has a new foe: a handheld device called Thermomed.

Cutaneous leishmaniasis major, which has affected some 1,300 American service members and civilians since the beginning of Operations Iraqi and Enduring Freedom, causes ulcer-like, non-healing sores on the skin around an infected bite.

Because the more common versions of leishmaniasis can infect the whole body, the only available medication is delivered intravenously and takes more than a week to run its course. In addition, the medicine, sodium stibogluconate, isn't approved by the U.S. Food and Drug Administration, so it has to be acquired under a research protocol.

For the military, this means high costs in paying for the medicine and in transporting troops stateside for weeks at a time to receive treatment.

Dr. Naomi Aronson, the director of the infectious diseases division at the Uniformed Services University of the Health Sciences, found a solution to that problem in Thermomed, a small device that can be used to treat skin infections using heat. Results from the randomized treatment trial, which involved 56 military personnel who contracted L. major while serving in Iraq, are reported March 5 in the open-access journal PLoS Tropical Neglected Diseases.

"This device allows quick, easy, portable treatment," Aronson said. "It worked just as well as our super-duper intravenous medicine for the infections we found in the desert."

The device uses two small tines, like a fork, to apply heat in a localized area. By applying that heat in a grid over an infected bite, Aronson found the parasite causing the infection can be killed quickly. Without treatment, the infection can take anywhere from six to 12 months to fully heal.

The effects of Thermomed treatment on the patient's skin are a small blister followed by a burn on the same level of pain as sunburn for a day. After that, discomfort was negligible.

For an infection this serious that can come as the result of an unassuming bug bite, it's a relief to have a quick, portable solution. Aronson said it's also beneficial because a leishmaniasis infection can be very scarring, and Thermomed devices are used in many cases to remove scars.

"Soldiers don't want to leave the theater for weeks to fix a skin sore," Aronson said. "This allows them to treat the infection without having to take troops out of action."

The treatment is simple: lidocaine is used to numb the skin around the sore, then the Thermomed is applied to make a small grid of burns over the affected skin and surrounding area. After a few days, the pain is gone and the infection is dead.