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Published on: July 15, 2011
Clinicohistological disparity in leprosy
S Majumdar1, G Srivastava, P Kumar
1Vivekananda Complex, 238 NSC Bose Road, Narendrapur, Kolkata.
Indian Journal of Dermatology, Venereology and Leprology
|July 24, 2007
Summary
This case highlights a rare presentation of leprosy in an elderly man, showing a discrepancy between clinical signs and histological findings. Early diagnosis and appropriate multidrug therapy (MDT) are crucial for preventing drug resistance and recurrence.
Area of Science:
- Dermatology
- Infectious Diseases
- Microbiology
Background:
- Leprosy diagnosis can be challenging, especially in atypical presentations.
- Clinicopathological disparities are not uncommon in leprosy, necessitating careful evaluation.
- Previous treatment with multidrug therapy (MDT) may influence clinical and histological findings.
Purpose of the Study:
- To report a unique case of leprosy with clinicohistological disparity.
- To emphasize the importance of accurate diagnosis and appropriate treatment in leprosy management.
- To discuss the implications of atypical presentations and treatment responses in leprosy.
Main Methods:
- Clinical examination of a localized skin lesion.
- Histopathological analysis of skin biopsy.
- Acid-fast bacilli (AFB) staining.
- Lepromin skin testing.
- Review of relevant literature on leprosy diagnosis and management.
Main Results:
- A localized, erythematous, anesthetic plaque clinically mimicking borderline tuberculoid (BT) leprosy with a reversal reaction.
- Histopathology revealed a borderline lepromatous (BL) granuloma with numerous solid-staining AFB in foamy macrophages.
- Lepromin test was weakly positive.
- Significant clinicohistological disparity was observed.
Conclusions:
- Atypical presentations of leprosy can occur even in elderly individuals.
- Clinicopathological disparity requires thorough investigation and consideration of alternative diagnoses or treatment responses.
- Adherence to newer multidrug therapy (MDT) regimens is essential to prevent drug resistance, relapse, and recurrence in leprosy.
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