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Severe reactional state in lepromatous leprosy simulating Sweet's syndrome.

T T Kou1, H L Chan

  • 1Department of Pathology, Chang Gung Memorial Hospital, Taipei, Taiwan.

International Journal of Dermatology
|October 1, 1987
PubMed
Summary

Leprosy can mimic Sweet's syndrome, presenting as an atypical erythema nodosum leprosum reaction. Treatment required both leprosy medication and steroid hormones to manage systemic symptoms.

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Area of Science:

  • Dermatology
  • Infectious Diseases
  • Rheumatology

Background:

  • Leprosy, a chronic infectious disease, can manifest with various mucocutaneous complications.
  • Sweet's syndrome is an acute febrile neutrophilic dermatosis characterized by fever, neutrophilia, and tender dermal infiltrates.
  • Erythema nodosum leprosum (ENL) is a common inflammatory complication of lepromatous leprosy, typically presenting as painful subcutaneous nodules.

Observation:

  • A male patient with lepromatous leprosy exhibited clinical symptoms resembling Sweet's syndrome.
  • The patient's presentation was interpreted as an unusual reactional state, a variant of erythema nodosum leprosum.

Findings:

  • The clinical presentation mimicked Sweet's syndrome, highlighting diagnostic challenges in leprosy complications.

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  • The atypical reactional state required a combination of standard antileprosy treatment and systemic steroid hormone therapy for symptom control.

    • Implications:

    • This case underscores the importance of considering leprosy reactions in the differential diagnosis of inflammatory dermatoses.
    • Recognition of atypical ENL variants is crucial for appropriate and timely patient management.
    • Systemic corticosteroids may be necessary for managing severe or atypical inflammatory manifestations of leprosy.