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[Leprosy disclosed by polyarthritis]
S Roul-Bouriat1, C Léauté-Labrèze, P Bobin
1Unité de Dermatologie Pédiatrique, Hôpital Pellegrin, Bordeaux.
Annales De Dermatologie Et De Venereologie
|January 29, 1999
Summary
A rare case of leprosy presented with misleading joint pain, mimicking connective tissue disease. Early diagnosis and treatment are crucial for managing this chronic Mycobacterium leprae infection.
Area of Science:
- Infectious Diseases
- Rheumatology
- Dermatology
Background:
- Leprosy (Hansen's disease) is a chronic infectious disease caused by Mycobacterium leprae.
- While typically presenting with neurological and cutaneous manifestations, rheumatological involvement can occur, often during leprous reactions.
- This case highlights a delayed presentation of leprosy in a traveler returning from an endemic area.
Observation:
- A 69-year-old woman with a history of living in Africa 30 years prior presented with inflammatory joint disease.
- Initial symptoms were attributed to connective tissue disease, leading to treatment with corticosteroids and anti-malarials.
- Progressive neurological and skin manifestations prompted further investigation, revealing lepromatous leprosy.
Findings:
- Histological examination confirmed lepromatous leprosy.
- The patient's rheumatological symptoms, neurological deficits, and skin lesions mimicked vasculitis.
- Corticosteroid therapy appeared to exacerbate the disease, leading to a purely lepromatous form.
Implications:
- This case underscores the importance of considering leprosy in patients with a travel history, even with atypical presentations.
- Misdiagnosis and delayed treatment can lead to disease progression and complications.
- Early and accurate diagnosis is essential for effective management of leprosy and its varied manifestations.