A Case of Saddle Nose Deformity Secondary to Lepromatous Leprosy

Area of Science:

• Infectious Diseases
• Dermatology
• Otolaryngology

Background:

• Leprosy is a chronic infectious disease caused by Mycobacterium leprae, primarily affecting skin and peripheral nerves.
• Lepromatous Leprosy patients can be asymptomatic for years, harboring bacteria in the nasal cavity and transmitting the disease.
• Advanced leprosy stages (4-5) frequently involve the nasal septum, causing saddle nose deformity.

Purpose of the Study:

• To highlight a rare presentation of saddle nose deformity mimicking atrophic rhinitis in the post-leprosy elimination era.
• To emphasize the importance of considering leprosy in differential diagnoses for refractory atrophic rhinitis cases.

Main Methods:

• Diagnosis was based on microbiological examination of nasal discharge.
• Acid-fast bacilli (AFB) staining (ZN Stain) was used for identification.
• Slit skin smear examination of ear lobule was performed.

Main Results:

• ZN Stain revealed acid-fast bacilli in globi, indicative of Mycobacterium Leprae.
• Slit skin smear of the right ear lobule was positive for AFB with a bacteriological index of 6+.

Conclusions:

• Leprosy should be considered a differential diagnosis for atrophic rhinitis unresponsive to standard treatment.
• Early diagnosis and prompt treatment of leprosy can minimize disease-related damage, including nasal deformities.
• This case underscores the need for vigilance in diagnosing leprosy even in post-elimination settings.