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Type 1 lepra reaction in histoid leprosy
Nidhi Singh1, Rashmi Kumari, Divya Gupta
1Departments of Dermatology and Sexually Transmitted Diseases, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
International Journal of Dermatology
|July 2, 2014
Summary
Type 1 lepra reaction is rare in histoid leprosy. A patient developed pruritic, painful skin lesions after starting multidrug therapy, which resolved with oral prednisolone.
Area of Science:
- Dermatology
- Infectious Diseases
- Pathology
Background:
- Histoid leprosy (HL) is a rare variant of lepromatous leprosy.
- Lepra reactions, particularly type 1, are infrequently reported in HL.
- Understanding HL and its reactional patterns is crucial for effective management.
Observation:
- A 42-year-old woman with no prior leprosy treatment presented with asymptomatic skin nodules.
- Histopathology confirmed histoid leprosy with abundant acid-fast bacilli (AFB).
- She developed a type 1 lepra reaction with pruritic, painful, erythematous, and edematous lesions after 10 weeks of multidrug therapy (MBMDT).
Findings:
- The type 1 lepra reaction in this case presented with pruritus and ulceration, previously unreported in HL.
- Histopathology showed epidermal atrophy, dermal edema, and AFB.
- Symptoms significantly improved within four weeks of initiating oral prednisolone treatment.
Implications:
- This case highlights that type 1 lepra reactions can manifest with pruritus and ulceration in histoid leprosy.
- Early recognition and appropriate treatment, including corticosteroids, are essential for managing lepra reactions in HL.
- Further research into the specific mechanisms and management of lepra reactions in HL is warranted.
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