Volume 81, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


A 31-year-old man with ankylosing spondylitis, receiving treatment with infliximab, presented with a large progressive cutaneous ulcer at the right knee. Biopsies showed amastigotes, and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis showed as the causative agent. After treatment with miltefosine, the ulcer resolved completely, and infliximab was reinstituted because of progression of spondylitis. After 1 year, there was a recurrent ulcer at the same site being positive for DNA by PCR. Local treatment with sodium stibogluconate resulted in complete regression. Cutaneous leishmaniasis should be added to the list of opportunistic infections associated with anti-tumor necrosis factor (TNF) treatment. Despite recurrences, antileish-manial treatment may be effective in cases without alternatives to anti-TNF therapy.


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  • Received : 16 Jan 2009
  • Accepted : 27 Mar 2009

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