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CASE REPORT |
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| Year : 2007 | Volume
: 52
| Issue : 4 | Page : 198 |
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| Atypical presentation of leprosy: A report of two cases |
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Sudip Das, Aloke Kr Roy, Chinmoy Kar, Parag Prasun Giri
NRS Medical College, Kolkata, West Bengal, India
Correspondence Address:
Sudip Das
P-103, Bosenagore Madhyamgram, 24-Parganas (N), Kolkatta, West Bengal
India
 Source of Support: None, Conflict of Interest: None  | Check |
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 |
| Introduction | |  |
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 | | |
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 | | |
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 | | |
| 1. | Sharma VK. Leprosy: Classification and clinical features. IADVL Text book of Dermatology. 3 rd ed. p. 1578-601.  |
| 2. | Bentekan L, Hassam B. Atypical presentations of leprosy: Apropos of 2 cases. Acta Leprologica 1997;10:195-8. |
| 3. | Suzuki Y, Takigawa M, Ishii N. A case of suspected multibacillary leprosy. Nihon Hansenbyo Gakkai Zasshi 2003;72:287-90. [PUBMED] |
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