ABSTRACT
Lepra reactions are acute episodes occurring during the disease process of leprosy and are of 2 types: type 1 or reversal reaction and type 2 reaction or erythema odosumleprosum (ENL). In the episodes of lepra reaction several parts are affected including face and extremities like oral cavity. In the present case report we reported a rare case of lepromatous leprosy with necrotic ENL involving scalp apart from the usual sites. A 58 year old married male presented to us with complaints of spontaneous onset, recurrent eruption of multiple reddish raised painful lesions. Biopsy from the infiltrated skin over the back showed atrophic epidermis, free Grenz zone, diffuse and periadnexal macrophage granulomas with predominant mononuclear infiltrate, appandageal atrophy, fibrosis around the neural structures and leukocytoclastic vasculitis. Fites stain showed strong positivity for M. leprae. His routine blood investigations showed anemia (Hb = 7.8 gm%), neutrophil leukocytosis (TLC = 17,600, DLC = P66L28M4E2) and raised ESR (80 mm in the first hour). These bullous and necrotic lesions in leprosy may be a manifestation of severe type II reactions in patients with very high bacillary load.
Subject(s)
Erythema Nodosum/etiology , Leprosy, Lepromatous/complications , Erythema Nodosum/immunology , Erythema Nodosum/microbiology , Erythema Nodosum/pathology , Humans , Leprosy, Lepromatous/microbiology , Male , Middle Aged , Mycobacterium leprae/isolation & purification , Mycobacterium leprae/physiology , Necrosis , Scalp/microbiology , Scalp/pathologyABSTRACT
28 yr old male presented with asymptomatic nodules and few well to ill defined papules on ears, asymmetrical nerve enlargement and evanescent tender nodules on the extremities without any infiltration of the skin and madarosis. Slit skin smear done from normal skin was BI 6+. Skin biopsy showed features of lepromatous leprosy.
Subject(s)
Leprosy, Lepromatous/diagnosis , Adult , Arm/microbiology , Arm/pathology , Ear, External/microbiology , Ear, External/pathology , Histiocytoma, Benign Fibrous/microbiology , Histiocytoma, Benign Fibrous/pathology , Histocytochemistry , Humans , Male , Skin/microbiology , Skin/pathologyABSTRACT
A twenty-six year old lady presented herself with multiple erythmatous, scaly, well-defined, hypo-esthetic plaques over bilateral soles, face and left leg. Histopathology revealed features consistent with borderline tuberculoid leprosy.
