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Cutaneous leishmaniasis associated with TNF-α blockers: a case report
  1. Pelayo Nieto Gómez1,
  2. Inmaculada Casas Hidalgo1,
  3. María de la Paz Casas Hidalgo2,
  4. Raquel Álvarez Sánchez1,
  5. Alejandro Rodríguez Delgado1,
  6. Jose Cabeza-Barrera3
  1. 1Farmacia Hospitalaria, Hospital Universitario San Cecilio, Granada, Spain
  2. 2Servicio de Microbiología y Parasitología, Hospital Universitario San Cecilio, Granada, Spain
  3. 3Pharmacy, Hospital Universitaro San Cecilio, Granada, Spain
  1. Correspondence to Pelayo Nieto Gómez, Farmacia Hospitalaria, Hospital Universitario San Cecilio, Granada 18012, Spain; pnietog90{at}gmail.com

Abstract

Leishmaniasis is a chronic protozoan disease that is found in diverse geographical areas of the world. Leishmania spp. are endemic in the Mediterranean coasts of southern Europe. Tumour necrosis factor alpha (TNF-α) plays an important role in the defence of the host against infection by Leishmania spp. In this case report we describe Leishmania infection caused by a monoclonal antibody against TNF-α: infliximab. A 51-year-old patient with psoriatic arthritis treated with infliximab, 5 mg/kg every 6 weeks as immunomodulatory treatment and methotrexate 10 mg weekly as a conventional disease-modifying antirheumatic drug, visited his otorhinolaryngologist owing to a lesion in his left nostril. The lesion was diagnosed as cutaneous leishmaniasis so treatment with infliximab was suspended. The patient was then treated with liposomal amphotericin B and showed a total recovery of the lesion; liposomal amphotericin B was maintained at 5 mg/kg monthly.

  • leishmaniasis
  • immunosuppression
  • infliximab
  • anti-tnf
  • psoriatic arthritis

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