Reactivation of cutaneous leishmaniasis in the context of non-HIV immunosuppression: a literature analysis

Abstract

Background: Immunosuppression increases the risk of primary cutaneous leishmaniasis (CL) infection and its reactivation. This systematic review examined CL reactivation in immunosuppressed patients, including those with autoimmune diseases and solid organ transplant recipients. Methods: A comprehensive literature search was conducted across multiple databases for studies published between May 1990 and May 2024. Results: Nine cases were selected, involving CL reactivation associated with immunosuppressive therapy for autoimmune diseases, such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis, or following renal transplantation. Conclusions: The management of CL during immunosuppressive therapy is challenging, necessitating different approaches for reactivation management.