First Case Report of Cutaneous Leishmaniasis Caused by Leishmania (Leishmania) infantum in a Brazilian Patient Treated with Adalimumab

Abstract

Leishmania (Leishmania) infantum is the main etiologic agent of visceral leishmaniasis in American continent. We report a rare case of cutaneous leishmaniasis caused by viscerotropic specie in a patient with ankylosing spondylitis on treatment with adalimumabe and methotrexate. The patient presented no signs of visceral involvement. PCR-RFLP and genetic sequencing demonstrated Leishmania (Leishmania) infantum. The patient was treated with N-methyl-glucamine (20 mgSbV/kg/day) for 20 days. Despite of interruption of treatment due to elevation of transaminases (TGO 48 U/L and TGP 62 U/L) for a week, the lesions healed completely.