Leprosy type-I reaction episode mimicking facial cellulitis-the importance of early diagnosis

Leprosy is aneasily recognizable disease due to its dermato-neurological manifestations. It must be present in the physician’s diagnostic repertoire, especially for those working in endemic areas. However, leprosy reaction is not always easily recognized by non-dermatologists, becoming one of the major problems in the management of patients with leprosy, as it presents clinical complications characterized by inflammatory process, accompanied by pain, malaise and sometimes the establishment or worsening of the patient’s disabilities. We report the case of a patient with type-1 periorbital reaction admitted to the hospital, diagnosed and treated as facial cellulitis, whose late diagnosis may have contributed to the appearance or worsening of facial neuritis.

Hanseníase dimorfa com acometimento articular: dificuldades no diagnóstico / Borderline leprosy with articular involvement: diagnostic difficulties

A hanseníase é doença infecciosa granulomatosa crônica causada pelo Mycobacterium leprae, um bacilo ácido-resistente com a sua predileção para afetar as áreas mais frias do corpo, como pele e nervos periféricos,o que torna o diagnóstico simples na maioria dos casos 1,2. No entanto, com base na resposta imune do paciente infectado, o envolvimento sistêmico pode ocorrer,principalmente nas formas multibacilares. Estes eventos são pouco encontrados, mas têm extrema relevância clínica devido à sua semelhança com doenças reumáticas 5, 6. Relata-se um caso de hanseníase confundida com artrite inespecífica em que o paciente apresentou inicialmente artralgia, edema das articulações, poliartrite e,finalmente, o aparecimento de lesões na pele. Em áreas endêmicas, os clínicos e reumatologistas deve sempre estar atentos sobre a hanseníase com essas manifestações iniciais.

Leprosy is a chronic caused by Mycobacterium leprae, an acid-fast bacillus with its predilection to affect the cooler areas of the body such as skin and peripheral nerves, which makes diagnosis simpler in most cases 1.2 granulomatous infectious disease . However, based on the immune response of the infected patient, systemic involvement may occur, characterized Multibacillary manner. These events are rarely found, but have extremelyclinical relevance because of its similarity with rheumatic diseases 5, 6. Report a case of leprosy confused with nonspecific arthritis in a patient who initially presented with joint pain, joint swelling, polyarthritis, and finally the appearance of skin lesions.