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Lepra lepromatosa nodular de diagnóstico tardío procedente de la Amazonía peruana, con el desarrollo de una reacción tipo 2 / Late diagnosis nodular lepromatous leprosy from the Peruvian Amazon, with development of a type 2 reaction
Villegas-Chiroque, Miguel; Maldonado-Gómez, Winston; Espino-Saavedra, Walter; Ventura-Flores, Roberto.
  • Villegas-Chiroque, Miguel; Hospital Regional Lambayeque. PE
  • Maldonado-Gómez, Winston; Hospital Regional Lambayeque. PE
  • Espino-Saavedra, Walter; Hospital Regional Lambayeque. PE
  • Ventura-Flores, Roberto; Hospital Regional Lambayeque. PE
Rev. chil. infectol ; 38(5): 707-712, oct. 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1388287
RESUMEN
Resumen La lepra o enfermedad de Hansen es una de las clásicas enfermedades olvidadas que aún persiste en Perú. La infección es ocasionada por Mycobacterium leprae. La enfermedad varía en un amplio rango de manifestaciones desde la lepra tuberculoide (paucibacilar) hasta la lepromatosa (multibacilar). Se presenta el caso de un varón de 55 años, agricultor y extractor de madera, procedente de la Amazonia peruana, con lesiones cutáneas antiguas infiltrantes en la cara, cuello, tórax, abdomen y extremidades. La baciloscopia y estudio histológico de una biopsia de piel confirmaron la presencia de bacilos ácido-alcohol resistentes. Se concluyó, en forma tardía, que fue un caso de lepra lepromatosa nodular. Recibió terapia con rifampicina, dapsona y clofamizina por dos años con una lenta mejoría; no obstante, cursó con un eritema nodoso leproso (reacción tipo 2) con buena respuesta a corticoesteroides y talidomida.
ABSTRACT
Abstract Leprosy or Hansen's disease is one of the classic neglected diseases that still persists in Peru. The infection is caused by Mycobacterium leprae. The disease varies in a wide range of manifestations from tuberculoid (paucibacillary) to lepromatous (multibacillary) leprosy. We present the case of a 55-year-old man, farmer and wood extractor, from the Peruvian Amazon with old infiltrating cutaneous lesions on the face, neck, thorax, abdomen and extremities. The smear and biopsy examinations confirm the presence of acid-alcohol-resistant bacilli compatible with leprosy. It is concluded, with a long delay, it was a case of nodular lepromatous leprosy. He received therapy with rifampicin, dapsone and clofamizine for two years with slow progressive improvement; however, he presented an erythema nodosum leprosum (type 2 reaction) with response to corticosteroids and thalidomide.
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Full text: Available Index: LILACS (Americas) Main subject: Leprosy, Lepromatous / Erythema Nodosum Type of study: Diagnostic study Limits: Humans / Male Country/Region as subject: South America / Peru Language: Spanish Journal: Rev. chil. infectol Journal subject: Communicable Diseases Year: 2021 Type: Article Affiliation country: Peru Institution/Affiliation country: Hospital Regional Lambayeque/PE

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Full text: Available Index: LILACS (Americas) Main subject: Leprosy, Lepromatous / Erythema Nodosum Type of study: Diagnostic study Limits: Humans / Male Country/Region as subject: South America / Peru Language: Spanish Journal: Rev. chil. infectol Journal subject: Communicable Diseases Year: 2021 Type: Article Affiliation country: Peru Institution/Affiliation country: Hospital Regional Lambayeque/PE