RESUMEN
Despite leprosy being eliminated worldwide, a reasonable number of new cases are encountered in many countries like India. Reactions in leprosy are quite common which contributes significantly to morbidity and disabilities in patients suffering from leprosy. Two types of reactions can occur in leprosy patients depending on host's immune response against Mycobacterium leprae. Lazarine leprosy is a rare ulcerating form of leprosy which is considered as an exaggerated type 1 reaction. We are reporting a case of facial lazarine leprosy in a normal immunocompetent person without any underlying malnutrition. This case presented with infiltrated, oedematous plaque with ulceration and crusting, features which are suggestive of Lazarine leprosy but can also be indicative of severe type 1 reaction. Aggressive nature of the lesion and ulceration were taken into consideration to diagnose this case as Lazarine leprosy.
RESUMEN
A 5 year old boy with a history of fall from a height of about 4 feet, presented after one week with swelling, watering and discharge of the right eye. He had severe conjunctival chemosis with superior displacement of the globe. Computed Tomography (CT) showed a linear low attenuation tract in the right orbit extending from the inferolateral wall up to the left uncinate process of the ethmoid bone with increasing Hounsfield unit after 10 days. The parents did not agree for early exploration. After 10 days an exploration was done and a large linear and irregular wooden foreign body (FB) measuring 4.5 x 1.5 cm2 was removed from the right orbit and a smaller one from the nasal cavity. Four weeks post surgery, his vision was 6/9 in the right eye with the eyeball in the normal position. This case was challenging because of the late presentation, parents not agreeing for early exploration, difficulty in diagnosing by CT and a large and very deep penetrating FB.