Mucocutaneous leishmaniasis in a patient with rheumatoid arthritis treated with adalimumab

Introduction: Human leishmaniasis is an infection caused by flagellated protozoa of the genus Leishmania. They are obligate intracellular parasites that selectively infect dendritic cells and macrophages. Development of cutaneous, mucocutaneous, or visceral disease depends on the Leishmania species involved and on the immune response of the host. Tumor necrosis factor alpha (TNF-α) cytokine has been implicated in macrophage activation and tissue granuloma formation, two activities linked to control of intracellular infection caused by Leishmania spp.