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

Author:

Palacios‐Diaz Rodolfo David1,Sahuquillo‐Torralba Antonio1,Rocamora‐Durán Vicenç2,Unamuno‐Bustos Blanca de1,Salavert‐Lleti Miguel3,Santos‐Alarcón Sergio4,Quintero Adriana5,Garcías‐Ladaria Joan6,Vila‐Payeras Aina7,Martínez‐Doménech Alvaro8,Mateu‐Puchades Almudena4,Nadal‐Lladó Cristina7,Botella‐Estrada Rafael19

Affiliation:

1. Dermatology Department Hospital Universitario y Politécnico La Fe Valencia Spain

2. Dermatology Department Hospital de Manacor Illes Baleares Spain

3. Infectious Diseases Department Hospital Universitario y Politécnico La Fe Valencia Spain

4. Dermatology Department Hospital Universitario Doctor Peset Valencia Spain

5. Pathology Department Hospital de Manacor Illes Baleares Spain

6. Dermatology Department Hospital Universitario Son Espases Illes Baleares Spain

7. Dermatology Department Hospital Universitario Son Llàtzer Palma de Mallorca Illes Baleares Spain

8. Dermatology Department. Hospital General Universitario de Valencia Spain

9. Department of Medicine Universitat de València Valencia Spain

Abstract

SummaryBackground and objectivesThe 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 methodsA 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.Results38 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.ConclusionsAlthough management should be individualized, maintenance of biologic therapy does not seem to interfere with treatment of CL or MCL.

Publisher

Wiley

Subject

Dermatology

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