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CASE REPORT
Year : 2007  |  Volume : 52  |  Issue : 4  |  Page : 198
Atypical presentation of leprosy: A report of two cases


NRS Medical College, Kolkata, West Bengal, India

Correspondence Address:
Sudip Das
P-103, Bosenagore Madhyamgram, 24-Parganas (N), Kolkatta, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.37726

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   Abstract 

We report two atypical presentation of leprosy-granuloma annulare like in a case of borderline tuberculoid leprosy, another erythema multiforme like lesion in borderline lepromatous leprosy.


Keywords: Atypical presentation, erythema multiforme, granuloma annulare, leprosy


How to cite this article:
Das S, Roy AK, Kar C, Giri PP. Atypical presentation of leprosy: A report of two cases. Indian J Dermatol 2007;52:198

How to cite this URL:
Das S, Roy AK, Kar C, Giri PP. Atypical presentation of leprosy: A report of two cases. Indian J Dermatol [serial online] 2007 [cited 2019 Sep 17];52:198. Available from: http://www.e-ijd.org/text.asp?2007/52/4/198/37726



   Introduction Top


The different manifestation of leprosy are known since time immemorial - numb hypopigmented or erythematous patches, localized paresthesia, shooting pains blisters of hands and feet, motor weakness, nasal stuffiness, epistaxis, synovial swelling of wrist, pedal edema, painless nodule, diminished over-excessive sweating have been reported. [1] But even today when we are trying hard to eradicate leprosy, newer forms of presentation continue to crop - laryngeal dyspnoea, [2] bullae with hematoma, [2] xanthoma [3] like presentation etc. [1]

We report two cases - one with granulome annulare like presentation and another with erythema multiforme like presentation.


   Case Report Top


A 45-year-old female patient was presented with a plaque on left arm of 3 cm in diameter. The plaque consists of multiple beaded papules with central clearing. There was 100% loss of sensation (touch, pain). We noticed slight shriveling of skin with loss of hair on the plaque. There was also a satellite plaque on interior and outer border of the lesion.

Histopathology of the lesion showed epidermal thinning, periappendageal and perivascular lymphohistocytic infiltrate with epitheloid cell granuloma.

Our another case was a case of borderline lepromatous leprosy presenting with erythema multiforme like lesion over back. There were multiple targetoid lesions along with erythematous hypo-aesthetic as well as normoesthetic small lesions beside nodules and ear lobe infiltration. Biopsy was done from two sites - one nodule and other from erythema multiforme lesions. Biopsy from the nodule showed foam cell granuloma with few acid fast bacilli. Biopsy from erythema multiforme like lesion showed feature suggestive of erythema multiforme.


   Discussion Top


We present these two cases because of atypicality of the presentation of lesions. Granuloma annulare-like presentation has not been reported earlier in literature and erythema multiforme-like presentation in Hansens disease is also not a very common finding.

 
   References Top

1.Sharma VK. Leprosy: Classification and clinical features. IADVL Text book of Dermatology. 3 rd ed. p. 1578-601.  Back to cited text no. 1    
2.Bentekan L, Hassam B. Atypical presentations of leprosy: Apropos of 2 cases. Acta Leprologica 1997;10:195-8.  Back to cited text no. 2    
3.Suzuki Y, Takigawa M, Ishii N. A case of suspected multibacillary leprosy. Nihon Hansenbyo Gakkai Zasshi 2003;72:287-90.  Back to cited text no. 3  [PUBMED]  




 

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    Abstract
    Introduction
    Case Report
    Discussion
    References

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