[Cutaneous leishmaniasis in polymyositis].
BACKGROUND
The prevalence of cutaneous leishmaniasis is increasing, especially in immunocompromized subjects.


METHODS
We report a case of particular interest, where a patient with steroid refractory polymyositis developed cutaneous leishmaniasis. Clinical outcome was favorable after institution of intralesional antimony therapy.


CONCLUSIONS
Cutaneous leishmaniasis is still recognized to be an opportunistic infection. Its frequency is indeed higher in immunocompromized subjects, mainly HIV-infected patients. In our patient, both polymyositis and steroid therapy were predisposing factors of cutaneous leishmaniasis onset; prednisone therapy has been postulated to be associated with immune dysfunction leading to: reduced blood T cells' levels (CD4 et CD8) as well as decreased cytokine synthesis (e.g. interferon gamma).
Marie
I
I
Département de Médecine Interne, CHU Rouen-Boisguillaume, 76031 Rouen cedex, France. isabelle.marie@chu-rouen.fr
Fevre
C
C
Favennec
L
L
Courville
P
P
Bernet
J
J
Levesque
H
H
D000328:Adult; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D018320:Leishmania major / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000150:complications* / Q000469:parasitology; D009894:Opportunistic Infections / Q000469:parasitology; D017285:Polymyositis / Q000150:complications* / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D011241:Prednisone