Scenario of Histoid Hansen at a Tertiary Care Hospital in South India

ABSTRACT

Histoid Hansen's disease is a form of lepromatous leprosy with characteristic bacterial morphology and very high bacillary load. The occurrence of de novo' Histoid leprosy in patients without other features of leprosy has been reported. We present our observations on eleven cases of Histoid Hansen's disease who had attended our Outpatient Department. A detailed clinical history and clinical examination was done. Slit skin smear for Bacteriological Index and skin biopsy were performed in all. All eleven cases were males. Cutaneous and subcutaneous nodules were the commonest skin lesions found. Slit skin smear revealed abundant organisms. Histopathology was consistent with Histoid Hansen. Seven were de novo cases. During treatment, one patient developed type II reaction. All patients except one showed clinical clearance of lesions and fragmented bacilli after one year of MB-MDT. The treatment was extended in this single case who did not respond well. Awareness about the clinical features, characteristic histology and early diagnosis of Histoid Hansen is of utmost importance. It will be important to determine the bacteriological and morphological indices at the end of the treatment for all Histoid Hansen disease patients. Continuation of treatment may be decided based upon the bacterial and morphological indices.