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

• Published in: Allergy (Copenhagen) 2012-12, Vol.67 (12), p.1609-1611
• Main Authors: Córdoba, S., Gandolfo Cano, M., Aguado, M., Huerta-Brogera, M., Romero, A., Martínez-Morán, C., Borbujo, J.
• Format: Article
• Language: English
• Subjects: Adult; Aged; allergens; Allergies; Biological and medical sciences; Clinical outcomes; Dermatology; drug allergy; Drug Hypersensitivity - diagnosis; Drug Hypersensitivity - etiology; Drug therapy; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Human protozoal diseases; Humans; Hypersensitivity, Delayed - chemically induced; Hypersensitivity, Delayed - diagnosis; immunologic tests; Infectious diseases; Injections, Intralesional; Leishmaniasis, Cutaneous - drug therapy; Leshmaniasis; Male; Medical sciences; Meglumine - administration & dosage; Meglumine - adverse effects; Meglumine - therapeutic use; Middle Aged; Organometallic Compounds - administration & dosage; Organometallic Compounds - adverse effects; Organometallic Compounds - therapeutic use; Parasitic diseases; Protozoal diseases; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Side effects; Skin diseases; Skin Tests
• ISSN: 0105-4538; 1398-9995
• DOI: 10.1111/all.12050

Background The pentavalent antimonials are considered the first‐choice drugs for treatment of leishmaniasis. Intralesional therapy is used to minimize the systemic effects of the drug. Methods Seventy patients were treated with weekly intralesional infiltrations of Glucantime® (meglumine antimoniate) for cutaneous leishmaniasis. Nine of them had infiltrated itchy erythematous and vesiculous plaques at the injection sites. Cutaneous tests were undertaken in eight patients. Results Prick tests were negative and seven of the eight patients showed positive intradermal tests with Glucantime® dilutions reading at D2 and D4. Only one patient had positive patch test to Glucantime a.i. Local reactions at the site of injection have been briefly mentioned in some reported series of leishmaniasis treated with intralesional or intramuscular meglumine antimoniate but the mechanism has never been explained before. Conclusions We report the first series of patients with local reactions at the injection sites of meglumine antimoniate in whom type IV hypersensitivity could be involved.