Clinical aspects and management of cutaneous leishmaniasis in rheumatoid patients treated with TNF-α antagonists.

Andreas L C Neumayr; Gloria Morizot; Leo G Visser; Diana N J Lockwood; Bernhard R Beck; Stefan Schneider; Guillaume Bellaud; Florence Cordoliani; Françoise Foulet; Emmanuel A Laffitte; Pierre Buffet; Johannes A Blum

doi:10.1016/j.tmaid.2013.05.003

Journal articles

Clinical aspects and management of cutaneous leishmaniasis in rheumatoid patients treated with TNF-α antagonists.

Andreas L C Neumayr ^{1, 2, *} Gloria Morizot ³ Leo G Visser ⁴ Diana N J Lockwood ⁵ Bernhard R Beck ⁶ Stefan Schneider ⁷ Guillaume Bellaud ⁸ Florence Cordoliani ⁹ Françoise Foulet ¹⁰ Emmanuel A Laffitte ¹¹ Pierre Buffet ^{3, 12} Johannes A Blum ^{1, 2, *}

* Corresponding author

1 Swiss Tropical and Public Health Institute [Basel]

2 Unibas - University of Basel

3 Département de Parasitologie Mycologie

4 Leiden University Medical Center (LUMC)

5 LSHTM - London School of Hygiene and Tropical Medicine

6 Tropen- und Reisemedizin am Bellevue

7 Department of Rheumatology

8 Service de Dermatologie Centre Hospitalier Universitaire

9 Department of Dermatology

10 Service de Parasitologie Mycologie

11 Clinic of Dermatology

12 Service de Parasitologie-Mycologie

Abstract : Patients under immunosuppressive therapy with tumor necrosis factor alpha (TNF-α) antagonists are vulnerable to various opportunistic infections including leishmaniasis. We present a case series of 8 travellers developing cutaneous leishmaniasis whilst on TNF-α antagonist treatment and review the literature on aspects of cutaneous leishmaniasis developing in patients treated with TNF-α antagonists. We make interim recommendations regarding the drug therapy used to maintain remission in travellers with rheumatoid disease travelling to leishmania prone areas. Despite having a medical condition requiring continued rheumatological review the interval to diagnosis appears not to be reduced compared to that described in non-rheumatoid patients. Rheumatologists and family doctors should be aware of the need for post-travel surveillance for leishmaniasis in rheumatoid patients on TNF-alpha antagonist treatment.

Keywords : Cutaneous leishmaniasis TNF-alpha antagonists Rheumatology Treatment Immunosuppression

Document type :

Journal articles

Domain :

Life Sciences [q-bio] / Human health and pathology / Infectious diseases

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https://hal-pasteur.archives-ouvertes.fr/pasteur-00939151
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Submitted on : Thursday, January 30, 2014 - 11:28:09 AM
Last modification on : Wednesday, August 19, 2020 - 11:16:45 AM

Clinical aspects and management of cutaneous leishmaniasis in rheumatoid patients treated with TNF-α antagonists.

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Clinical aspects and management of cutaneous leishmaniasis in rheumatoid patients treated with TNF-α antagonists.

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