Delayed allergic skin reactions due to intralesional meglumine antimoniate therapy for cutaneous leishmaniasis

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Published on: April 21, 2012

S Córdoba1, M Gandolfo Cano, M Aguado

  • 1Dermatology, Hospital Universitario de Fuenlabrada, Madrid, Spain. scordoba.hflr@salud.madrid.org

Allergy
|October 17, 2012
PubMed
Abstract

Insights

Local reactions to Glucantime injections for leishmaniasis may indicate a type IV hypersensitivity. This study investigated these reactions, suggesting a delayed hypersensitivity mechanism in patients receiving meglumine antimoniate.

Area of Science:

  • Dermatology
  • Immunology
  • Infectious Diseases

Background:

  • Pentavalent antimonials, such as meglumine antimoniate (Glucantime®), are primary treatments for leishmaniasis.
  • Intralesional therapy is employed to reduce systemic adverse effects of antimonial drugs.

Purpose of the Study:

  • To investigate the cause of local reactions observed at injection sites during intralesional Glucantime® therapy for cutaneous leishmaniasis.
  • To determine if hypersensitivity reactions are involved in the local adverse effects.

Main Methods:

  • Seventy patients with cutaneous leishmaniasis received weekly intralesional Glucantime®.
  • Nine patients developed infiltrated, itchy, erythematous, and vesiculous plaques at injection sites.
  • Cutaneous tests, including prick, intradermal, and patch tests, were performed on eight affected patients.

Main Results:

  • Prick tests with Glucantime® were negative in all tested patients.
  • Intradermal tests showed positive reactions in seven out of eight patients at D2 and D4.
  • One patient had a positive patch test to Glucantime® active ingredient.

Conclusions:

  • This study presents the first series of patients experiencing local reactions at meglumine antimoniate injection sites.
  • Type IV hypersensitivity (delayed-type hypersensitivity) is implicated as a potential mechanism for these local reactions.

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