@article{22173,
  keywords = {Antibodies, Monoclonal, Antitubercular Agents, Humans, Immunosuppressive Agents, Infliximab, Latent Tuberculosis, Leprostatic Agents, Leprosy, Borderline, Male, Middle Aged, Mycobacterium leprae, Mycobacterium tuberculosis, Opportunistic Infections, Psoriasis, Tumor Necrosis Factor-alpha},
  author = {Teixeira FM and Vasconcelos LMF and Rola CAD and Prata de Almeida TL and Valenca JT and Nagao-Dias AT},
  title = {Secondary leprosy infection in a patient with psoriasis during treatment with infliximab.},
  abstract = {<p>Tumor necrosis factor α antagonists are proven to be effective for the treatment of chronic inflammatory conditions, such as psoriasis. A major concern for patients is the risk of acquiring granulomatous infectious diseases caused by the immunosuppressive effects of the drugs. We report a 60-year-old man with psoriasis who underwent infliximab treatment for 2 years and developed secondary leprosy, presenting extensive erythematous and infiltrated plaques on the trunk and limbs with loss of sensitivity (thermal, pain and tactile). The skin lesion biopsy showed perivascular epithelioid granulomas, nodular dermal aggregates of foamy macrophages and bundles of acid-fast bacilli. The clinical picture associated with histopathologic evaluation suggested borderline lepromatous leprosy. Before infliximab treatment, the patient had a positive tuberculin skin test and underwent chemoprophylaxis treatment for latent tuberculosis. Although the tuberculin reactivity suggests a strong correlation with a latent Mycobacterium tuberculosis infection, the possibility of infections by other mycobacteria, such as Mycobacterium leprae, should not be discarded.</p>},
  year = {2011},
  journal = {Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases},
  volume = {17},
  pages = {269-71},
  month = {2011 Aug},
  issn = {1536-7355},
  doi = {10.1097/RHU.0b013e3182288870},
  language = {eng},
}