01437nas a2200253   4500000000100000008004100001260001700042653001200059653002500071653002000096653001100116100001600127700001600143700001700159700001600176700001600192245009900208856007300307300000900380490000700389050001700396520075600413022001401169       2013                            d  c2013 Nov-Dec10aleprosy10aRheumatoid arthritis10aAdverse effects10aBrazil1 aAntônio JR1 aSoubhia RMC1 aPaschoal VDA1 aAmarante CF1 aTravolo ARF00aBiological agents: investigation into leprosy and other infectious diseases before indication.  uhttp://www.scielo.br/pdf/abd/v88n6s1/0365-0596-abd-88-06-s1-0023.pdf  a23-50 v88  aANTONIO 20133 aBiological agents are widely used for various immune-mediated diseases, with remarkable effectiveness in the treatment of rheumatoid arthritis (RA), psoriasis, psoriatic arthritis, ankylosing spondylitis and Crohn's disease. However, attention needs to be drawn to the adverse effects of these therapies and the risk of reactivating underlying granulomatous infectious diseases such as tuberculosis, leprosy, syphilis, leishmaniasis, among others. The objective of this paper is to describe a case of leprosy in a patient with RA using anti-TNF alfa, demonstrating the need for systematic investigation of skin lesions suggestive of leprosy in patients who require rheumatoid arthritis therapeutic treatment, especially in endemic regions like Brazil.  a1806-4841