Clinicopathological characteristics of cutaneous and mucocutaneous leishmaniasis in patients treated with TNF‐α inhibitors

• Published in: Journal der Deutschen Dermatologischen Gesellschaft Vol. 21; no. 5; pp. 473 - 480
• Main Authors: Palacios‐Diaz, Rodolfo David, Sahuquillo‐Torralba, Antonio, Rocamora‐Durán, Vicenç, Unamuno‐Bustos, Blanca de, Salavert‐Lleti, Miguel, Santos‐Alarcón, Sergio, Quintero, Adriana, Garcías‐Ladaria, Joan, Vila‐Payeras, Aina, Martínez‐Doménech, Alvaro, Mateu‐Puchades, Almudena, Nadal‐Lladó, Cristina, Botella‐Estrada, Rafael
• Format: Journal Article
• Language: English
• Published: Germany Wiley Subscription Services, Inc 01.05.2023
• Subjects: Antiprotozoal Agents - therapeutic use; biologic drugs; cutaneous leishmaniasis; Humans; Immunologic Factors - therapeutic use; Immunosuppression; Inflammatory diseases; Leishmaniasis, Cutaneous - diagnosis; Leishmaniasis, Cutaneous - drug therapy; Leishmaniasis, Cutaneous - pathology; Leishmaniasis, Mucocutaneous - diagnosis; Leishmaniasis, Mucocutaneous - drug therapy; Meglumine antimoniate; Meglumine Antimoniate - therapeutic use; Mucocutaneous leishmaniasis; Parasitic diseases; Psoriasis; Retrospective Studies; systemic involvement; TNF‐α; Tumor Necrosis Factor Inhibitors; Tumor necrosis factor-TNF; inflammatory diseases; systemic involvement; Psoriasis; TNF-α; biologic drugs; cutaneous leishmaniasis
• ISSN: 1610-0379; 1610-0387
• DOI: 10.1111/ddg.15007

Summary Background and objectives The increasing use of biologics in the treatment of inflammatory diseases has led to more cases of leishmaniasis in patients subjected to iatrogenic immunosuppression. The main objective was to describe the characteristics of the patients with cutaneous (CL) or mucocutaneous (MCL) leishmaniasis who were receiving a biological therapy at the time of diagnosis. Patients and methods A multicenter retrospective study was design based on a cohort of patients diagnosed with CL or MCL. All patients who were being treated with biologicals were included. For each case, two matched non‐exposed patients were included for comparison. Results 38 patients were diagnosed with CL or MCL while being treated with tumor necrosis factor alpha (TNF‐α) inhibitors. Leishmaniasis presented more frequently as a plaque (58.3%) with a larger median lesion size (2.5 cm), ulceration (92.1%), and required a greater median number of intralesional meglumine antimoniate infiltrations (3 doses) (P < 0.05) than in non‐exposed patients. We found no systemic involvement in patients being treated with anti‐TNF‐α. We did not find differences regarding the treatment characteristics whether biologic therapy was modified or not. Conclusions Although management should be individualized, maintenance of biologic therapy does not seem to interfere with treatment of CL or MCL.