CASE REPORT
Multifocal cutaneous leishmaniasis in a patient treated with golimumab for psoriaticarthritis
1
Division of Pathology, San Salvatore Hospital, L’Aquila, Italy
2
Dermatology Unit, Primary Health Care District, L’Aquila, Italy
3
Division of Nuclear Medicine, San Salvatore Hospital, L’Aquila, Italy
4
Division of Pathology, San Camillo de’ Lellis Hospital, Italy
Submission date: 2024-10-03
Final revision date: 2025-02-07
Acceptance date: 2025-03-05
Publication date: 2025-09-22
Corresponding author
Luca Ventura
Luca Ventura Division of Pathology, San Salvatore Hospital, via Lorenzo Natali 1 – Coppito, 67100 L'Aquila, Italy
Luca Ventura Division of Pathology, San Salvatore Hospital, via Lorenzo Natali 1 – Coppito, 67100 L'Aquila, Italy
Pol J Pathol 2025;76(2):158-162
KEYWORDS
TOPICS
ABSTRACT
Leishmaniasis is a zoonosis caused by protozoans transmitted by sandflies. Immunosuppression is a risk factor for developing leishmaniasis in patients treated with TNF inhibitors for autoimmune diseases. A 65-year-old man with a 14-year history of psoriatic arthritis in treatment with methotrexate, treated with golimumab during the last 2.5 years, presented ulcerations of the buttocks and upper back. Histopathological findings allowed us to yield the diagnosis of cutaneous leishmaniasis. Therapy was suspended and the patient underwent appropriate treatment. Five cases of leishmaniasis in patients treated with golimumab were reported in literature and ten cases were mentioned in retrospective reviews.
REFERENCES (24)
1.
López-Medina C, Doblas A, Escudero-Contreras A, Collantes-Estévez E. Safe Treatment With Secukinumab in a Patient With Axial Spondyloarthritis and a History of a Leishmania donovani Infection. J Rheumatol 2023; 50: 1521-1522.
2.
Kurizky PS, Marianelli FF, Cesetti MV, et al. A comprehensive systematic review of leishmaniasis in patients undergoing drug-induced immunosuppression for the treatment of dermatological, rheumatological and gastroenterological diseases. Rev Inst Med Trop Sao Paulo 2020; 62: e28.
3.
Scholl S, Schuster D, Technau-Hafsi K, et al. Case report: Cutaneous pseudolymphoma caused by a Leishmania infantum infection in a patient treated with anti-TNF antibody for plaque psoriasis. Front Med (Lausanne) 2022; 9: 1055703.
4.
Lupia T, Corcione S, Fornari V, et al. Visceral Leishmaniasis after Anti-Interleukin 17A (IL-17A) Therapy in a Patient Affected by Psoriatic Arthritis. Trop Med Infect Dis 2022; 7: 319.
5.
Billings SD, Cotton J. Inflammatory dermatopathology. A pathologist’s survival guide. 2nd Edition. Springer, Cham 2016.
6.
Busam KJ. Dermatopathology. A Volume in a Series: Foundations in Diagnostic Pathology. Series Editor: Goldblum JR. 2nd Edition. Elsevier Saunders, Philadelphia 2014.
7.
Fernandez-Flores A. A new scenario in the immunohistochemical diagnosis of cutaneous leishmaniasis. J Cutan Pathol 2017; 44: 1051-1052.
8.
Sundharkrishnan L, North JP. Histopathologic features of cutaneous leishmaniasis and use of CD1a staining for amastigotes in Old World and New World leishmaniasis. J Cutan Pathol 2017; 44: 1005-1011.
9.
Ferrufino-Schmidt MC, Bravo F, Valencia BM, Llanos-Cuentas A, Boggild AK, LeBoit PE. Is CD1a useful for leishmaniasis diagnosis in the New World?. J Cutan Pathol 2019; 46: 90-92.
10.
DeCoste R, Walsh NM, Pasternak S. The EP3622 clone of CD1a in the diagnosis of cutaneous leishmaniasis. J Cutan Pathol 2020; 47: 666-667.
11.
Hammond AM, Kallis PJ, Sokumbi O, Auerbach J, Vincek V, Motaparthi K. The EP3662 clone of CD1a supports the diagnosis of New World cutaneous leishmaniasis. J Cutan Pathol 2021; 48: 1317-1320.
12.
Lopez-Trujillo E, Gonzàlez-Farré M, Pujol RM, et al. Diagnostic usefulness of immunohistochemical evaluation of CD1a antigen and polyclonal anti-leishmania antibodies in cutaneous leishmaniasis. Histol Histopathol 2021; 36: 567-576.
13.
Neumayr AL, Morizot G, Visser LG, et al. Clinical aspects and management of cutaneous leishmaniasis in rheumatoid patients treated with TNF-a antagonists. Travel Med Infect Dis 2013; 11: 412-420.
14.
Bagalas V, Kioumis I, Argyropoulou P, Patakas D. Visceral leishmaniasis infection in a patient with rheumatoid arthritis treated with etanercept. Clin Rheumatol 2007; 26: 1344-1345.
15.
Kritikos K, Haritatos E, Tsigkos S, et al. An atypical presentation of visceral leishmaniasis infection in a patient with rheumatoid arthritis treated with infliximab. J Clin Rheumatol 2010; 16: 38-39.
16.
Moltó A, Mateo L, Lloveras N, Olivé A, Minguez S. Visceral leishmaniasis and macrophagic activation syndrome in a patient with rheumatoid arthritis under treatment with adalimumab. Joint Bone Spine 2010; 77: 271-273.
17.
Balato A, Balato N, Patruno C, Gallo L, Ayala F. Visceral leishmaniasis infection in a patient with psoriasis treated with efalizumab. Dermatology 2008; 217: 360-361.
18.
Nieto Gómez P, Casas Hidalgo I, Casas Hidalgo MP, Álvarez Sánchez R, Rodríguez Delgado A, Cabeza-Barrera J. Cutaneous leishmaniasis associated with TNF-a blockers: a case report. Eur J Hosp Pharm 2019; 26: 233-234.
19.
Palacios-Diaz RD, Sahuquillo-Torralba A, Rocamora-Durán V, et al. Clinicopathological characteristics of cutaneous and mucocutaneous leishmaniasis in patients treated with TNF-a inhibitors. J Dtsch Dermatol Ges 2023; 21: 473-480.
20.
Glans H, Dotevall L, Van der Auwera G, et al. Treatment outcome of imported cutaneous leishmaniasis among travelers and migrants infected with Leishmania major and Leishmania tropica: a retrospective study in European centers 2013 to 2019. Int J Infect Dis 2022; 122: 375-381.
21.
Guarneri C, Bevelacqua V, Patterson JW, Tchernev G. Cutaneous and visceral leishmaniasis during anti-TNFa therapy. Wien Med Wochenschr 2017; 167: 78-82.
22.
Souza RM, Andrade HF Junior, Duarte MI, et al. Reactivation of cutaneous and mucocutaneous tegumentary leishmaniasis in rheumatoid arthritis patients: an emerging problem? Rev Inst Med Trop Sao Paulo 2017; 59: e6.
23.
Bosch-Nicolau P, Ubals M, Salvador F, et al. Leishmaniasis and tumor necrosis factor alpha antagonists in the Mediterranean basin. A switch in clinical expression. PLoS Negl Trop Dis 2019; 13: e0007708.
24.
Hammarström H, Moreno J, Dotevall L, Calander AM. Leishmania infantum infection after visiting southern Spain in patients on biological treatment; an observational, longitudinal, cohort study. Travel Med Infect Dis 2023; 53: 102570.
| eISSN: | 2084-9869 |
| ISSN: | 1233-9687 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
