[Cutaneous leishmaniasis in polymyositis]

Area of Science:

• Infectious Diseases
• Immunology
• Dermatology

Background:

• Cutaneous leishmaniasis (CL) prevalence is rising, particularly in immunocompromised populations.
• CL is an opportunistic infection often associated with conditions like HIV.
• Polymyositis and its treatment can compromise immune function, increasing susceptibility to CL.

Observation:

• A case of cutaneous leishmaniasis in a patient with steroid-refractory polymyositis is presented.
• The patient's polymyositis and prednisone therapy were identified as predisposing factors for CL.
• Prednisone therapy may lead to immune dysfunction, including reduced T cell counts and impaired cytokine synthesis.

Findings:

• Intralesional antimony therapy resulted in a favorable clinical outcome for the patient.
• The case highlights the role of iatrogenic immunosuppression in the development of CL.
• Immune dysfunction, characterized by decreased CD4/CD8 T cells and interferon-gamma, was observed.

Implications:

• This case underscores the importance of recognizing CL in immunocompromised patients, including those with autoimmune diseases on immunosuppressive therapy.
• Effective treatment options like intralesional antimony should be considered for CL in such cases.
• Further research into the immunomodulatory effects of immunosuppressive therapies and their link to opportunistic infections is warranted.