Cutaneous Leishmaniasis in Patients under Biologic Therapies: A Spanish CLINI-AEDV Multicentre Study

Anti-TNFα agents have been associated with the reactivation of granulomatous infections, including leishmaniasis. Cases of atypical or recurrent cutaneous (CL) or mucocutaneous leishmaniasis (MCL) have been reported in patients on biologics. We conducted a retrospective analysis of a multicenter database to describe the clinical characteristics and management of CL and MCL in patients receiving biological therapy in an endemic area. Clinical features, diagnostics, therapies, and outcomes were analyzed. Seventy-one patients were included (63 CL and 8 MCL). The most common underlying condition was inflammatory bowel disease (33.8%). Lesions were multifocal in 40% and larger than 1 cm in 94.4%. Treatment failures were more frequent in MCL (50%) than CL (8.1%). Biologic therapy was discontinued in 53.5%, leading to worsening of the underlying disease in 44.7%. No significant difference in cure rates was observed between patients who continued vs. discontinued biologics (p=0.868). These findings highlight the clinical burden of CL and MCL in patients undergoing anti-TNFα therapy and suggest that discontinuation of biologic therapy did not significantly impact cure rates, emphasizing the need for standardized strategies balancing infection control and underlying inflammatory disease management.

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Journal
Acta Dermato Venereologica
Published
2026-03-12
DOI
https://doi.org/10.2340/actadv.v106.adv-2025-0132
Primary Topic
Research on Leishmaniasis Studies
Type
article
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article

Cutaneous Leishmaniasis in Patients under Biologic Therapies: A Spanish CLINI-AEDV Multicentre Study

Vicente Exposito-Serrano, Emili Masferrer, Mireia Esquius Rafat, Álvaro Aguado Vázquez et al.
Acta Dermato Venereologica
Research on Leishmaniasis Studies
article

Cutaneous Leishmaniasis in Patients under Biologic Therapies: A Spanish CLINI-AEDV Multicentre Study

Vicente Exposito-Serrano, Emili Masferrer, Mireia Esquius Rafat, Álvaro Aguado Vázquez, Irene Ballester Nortes, R. Botella Estrada, María del Mar Blanes Martínez, Irene Fuertes, V. Rocamora Duran, David Pesqué, Ramón M. Pujol, Bernat Mas Matas, Andrea Ciudad, Gemma Martin-Ezquerra, P. Mercader-García, Miquel Armengot-Carbo Armengot-Carbo, M A Lasheras-Perez, M. Llamas-Velasco, Adrián Imbernón-Moya, Verónica Tapia, Miguel Ángel Descalzo, Ignacio García-Doval, P. Garbayo-Salmons, Esther Roé Crespo, Amador Solá-Truyols, Fernándo Gallardo, Diego De la Vega-Ruiz, Laura Alonso Naranjo
article en

Abstract

Anti-TNFα agents have been associated with the reactivation of granulomatous infections, including leishmaniasis. Cases of atypical or recurrent cutaneous (CL) or mucocutaneous leishmaniasis (MCL) have been reported in patients on biologics. We conducted a retrospective analysis of a multicenter database to describe the clinical characteristics and management of CL and MCL in patients receiving biological therapy in an endemic area. Clinical features, diagnostics, therapies, and outcomes were analyzed. Seventy-one patients were included (63 CL and 8 MCL). The most common underlying condition was inflammatory bowel disease (33.8%). Lesions were multifocal in 40% and larger than 1 cm in 94.4%. Treatment failures were more frequent in MCL (50%) than CL (8.1%). Biologic therapy was discontinued in 53.5%, leading to worsening of the underlying disease in 44.7%. No significant difference in cure rates was observed between patients who continued vs. discontinued biologics (p=0.868). These findings highlight the clinical burden of CL and MCL in patients undergoing anti-TNFα therapy and suggest that discontinuation of biologic therapy did not significantly impact cure rates, emphasizing the need for standardized strategies balancing infection control and underlying inflammatory disease management.

Acta Dermato VenereologicaVol. 106
Hospital Sant Joan de Déu Barcelona (ES), Universitat Pompeu Fabra (ES), Hospital de Sant Pau (ES), Hospital Universitari i Politècnic La Fe (ES), Hospital Son Llatzer (ES), Hospital General Universitario Morales Meseguer (ES), Hospital Terrassa (ES), Hospital Universitario de Gran Canaria Doctor Negrín (ES), Hospital Universitario Fundación Alcorcón (ES), Spanish Academy of Dermatology and Venereology (ES), Fundación Hospital Manacor (ES), Hospital Clínic de Barcelona (ES), Corporació Sanitària Parc Taulí (ES), Hospital de Sabadell (ES), Hospital General Universitari de Castelló (ES), Hospital Universitario Doctor Peset (ES), Hospital Universitario de La Princesa (ES), Hospital Del Mar (ES), Hospital General Universitario de Alicante Doctor Balmis (ES), Hospital Universitario Severo Ochoa (ES)
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Research on Leishmaniasis Studies
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