No abstract available.
Acupuncture ; Foreign Bodies ; Granuloma, Foreign-Body ; Leprosy ; Leprosy, Lepromatous

We report a 23-year-old male with lepromatous leprosy atypically presenting with 5-year history of asymptomatic, verrucous papules, and nodules. Human Immunodeficiency Virus (HIV) testing was positive with depressed CD4 count. In HIV/leprosy co-infection, most of the documented patients were diagnosed with paucibacillary leprosy as immune reconstitution disease (IRD) from treatment-induced immunological recovery. Rarely, multibacillary lepromatous leprosy is encountered in the setting of untreated, severe immunodeficiency. Atypical clinical presentation warrants investigation for concurrent HIV infection.

BACKGROUND: The causative agents of leprosy are the well-known Mycobacterium leprae and the newly discovered Mycobacterium lepromatosis. This agent was found in 2008, and it was found to be the cause of diffuse lepromatous leprosy in two Mexican patients. OBJECTIVE: The objective of this work was to determine if M. leprae and M. lepromatosis were present in formalin-fixed and paraffin-embedded skin samples from cases from different regions in Mexico. METHODS: A total of 41 skin samples were obtained from 11 states of Mexico. All patients' samples were diagnosed by clinical and histopathological analyses. Total DNA was isolated using a Qiagen-DNeasy blood and tissue kit and molecular identification was achieved by two semi-nested polymerase chain reactions. RESULTS: The 41 patient included 33 samples from men and 8 samples from women; 29 samples were polymerase chain reaction (PCR)-positive to Mycobacterium and 12 samples were PCR-negative. From those 29 samples, 13 were PCR-positive to M. leprae, 8 to M. lepromatosis and 8 were positive to both species. The histopathological diagnosis included; Nodular lepromatous leprosy (NLL); Diffuse lepromatous leprosy (DLL); and Borderline leprosy (BL). The 29 PCR-positive samples were classified as follow: 14 NLL, 4 DLL, and 11 BL. In the 12 samples negative to Mycobacterium, 7 showed the NLL, 2 DLL and 3 BL. CONCLUSION: These findings add evidence to the M. leprae and M. lepromatous distribution, clinical forms and participation of dual infections in Mexico.
Diagnosis ; DNA ; Female ; Hospital Distribution Systems ; Humans ; Leprosy ; Leprosy, Borderline ; Leprosy, Lepromatous ; Male ; Mexico* ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction ; Skin*

Hansen's disease (leprosy) is a chronic infectious disease caused by Mycobacterium leprae which affect mainly skin and nerve systems. Currently the incidence of leprosy reached the goals set by WHO in the year 2000. In recent 10 years, only 47 new patients were found in Koreans and their average age was over 70. A 21 year-old young man showed multiple erythematous papules, macules and plaque at face, extremities and trunk. In family history, his grandfather was diagnosed with leprosy at young age and leprosy was recurred when the patient was 7 years old. The patient lived with grandfather from birth to 7 years old. Clinico-pathologically he was diagnosed with a lepromatous leprosy. We performed VNTR both at the skin tissue of grandfather and patient to find out the infection pathway of the patient and found some consistent. Herein, we report a new case of young Korean male transmitted from grandfather.
Communicable Diseases ; Extremities ; Grandparents ; Humans ; Incidence ; Leprosy* ; Leprosy, Lepromatous ; Male ; Minisatellite Repeats ; Mycobacterium leprae ; Parturition ; Skin

No abstract available.
Granuloma* ; Leprosy, Lepromatous*

Lepra reaction is an acute exacervational status occurring in the chronic course of leprosy. Type 2 lepra reaction occur from multibacillus leprosy (such as BL or LL), which mediated by antigen-antibody immune complex deposited vasculitis, involving multiple organs, and usually associated with constitutional symptoms such as fever, malaise, joint pains. The skin lesions is characterized by painful and tender red papules or nodules on the skin, which also refers to erythema nodosum leprosum (ENL). Different rare atypical skin lesions of ENL have been reported such as bullous, ulcerative, necrotic, pustular, sweet syndrome like lesions in literature. The 74 years old male patient with lepromatous leprosy presented as multiple crusted ulcers on the trunk and red edematous nodule on extremities and face. The histopathologic feature was typical for type 2 lepra lesion. Fite stain revealed large histiocytes containing well defined dense granular bacillus. This case was very rare and interesting because of unusual crusted ulcerative skin lesions combined with conventional ENL lesions and leprosy itself is rare in Korea these days.
Antigen-Antibody Complex ; Arthralgia ; Bacillus ; Erythema Nodosum ; Extremities ; Fever ; Histiocytes ; Humans ; Korea ; Leprosy ; Leprosy, Lepromatous* ; Male ; Skin* ; Sweet Syndrome ; Ulcer* ; Vasculitis

Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae and may manifest variable symptoms and signs. A 63-year-old woman developed multiple erythematous subcutaneous nodules on her trunk and extremities and experienced arthralgia. She had been receiving treatment for rheumatoid arthritis. On physical examination, she had atrophy of the hypothenar and thenar muscles, a claw hand, and peripheral neuropathy. Systemic symptoms were accompanied by fatigue, myalgia, malaise, and appetite loss. Histologic examination showed large foamy histiocytes forming granulomas, and numerous acid-fast bacilli and globi were detected on Fite stain. We report lepromatous leprosy mimicking rheumatoid arthritis to highlight the typical manifestation of leprosy mimicking other diseases.
Animals ; Appetite ; Arthralgia ; Arthritis, Rheumatoid* ; Atrophy ; Extremities ; Fatigue ; Female ; Granuloma ; Granulomatous Disease, Chronic ; Hand ; Histiocytes ; Hoof and Claw ; Humans ; Leprosy ; Leprosy, Lepromatous* ; Middle Aged ; Muscles ; Myalgia ; Mycobacterium leprae ; Peripheral Nervous System Diseases ; Physical Examination

Leprosy is an important health problem worldwide yet. It is caused by a chronic granulomatous infection of the skin and peripheral nerves with Mycobacterium leprae. The clinical findings from tuberculoid to lepromatous leprosy are a result of variation in the cellular immune response to the mycobacterium. The resulting impairment of nerve function causes the disabilities associated with leprosy. The widespread implementation of multi-drug therapy (MDT) has been associated with a fall in the prevalence of the leprosy but as yet no reduction in the case-detection rate globally. The leprosy control activities must be maintained for decades to interrupt transmission of infection. Based on the discovery of three single nucleotide polymorphisms (SNPs) in Mycobacterium leprae, it has been previously reported that there are four major SNP types associated with different geographic regions around the world. To expand the analysis of geographic distribution of M. leprae, classified by SNP, the author studied 56 clinical isolates from Korea isolates. And analysis SNP genotyping by PCR amplification and sequencing, PCR-RFLP, and pyrosequencing. The genotype of single-nucleotide polymorphism type 3, CTC, at positions 14676, 164275, and 2935685, was predominant (95%) for isolates originating in Korea.
Genotype ; Immunity, Cellular ; Korea ; Leprosy ; Leprosy, Lepromatous ; Mycobacterium ; Mycobacterium leprae ; Peripheral Nerves ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Prevalence ; Skin

Adult ; Diagnostic Errors ; Humans ; Leprosy, Lepromatous ; diagnosis ; Male ; Sinusitis ; diagnosis

Hansens' disease is well known chronic inflammatory granulomatous disease by Macobacterium leprae., and occur rarely in these days. The wide range of clinical manifestations develop by status of the host resistant. These are from mild sensory change, erythematous macular patches, diffuse infiltrating plaque, and nodules to severe destruction of peripheral nerve and internal organ involvements. Vitilgo and xanthelasma rarely may occur in the lepromatous leprosy. The patient was a 60-year-old a farmer who complained erythematous diffuse ill defined infiltrative plaques or nodules on the face, trunk. He was diagnosed as lepromatous leprosy by skin biopsy and fite staining and had taken the standard 3 multidrug (dapsone, rifampicin, lamprene)therapy. About 3 months during the therapy, the existing skin lesions became erythematous and mild edematous, some of which show vitiligo like change, and severe general aching and neuralgia developed. Type 1 lepra reaction with upgrading was diagnosed by clinical symptoms and skin biopsy feature. The vitiligo lesions also appeared on the normal looking skin without previous lepromatous lesion. At that time, yellowish plaque appeared on both eyelid and diagnosed as xanthelasma without hypolipoproteinemia. The mutidrug therapy for lepsory continued and oral predinsolone was given for the general aching of neuralgia. The lepra skin lesions had been improved gradually and the vitiligo lesions also disappeared. Presenting case is very interesting in point of view that he had vitiligo related to type 1 lepra reaction, and simultaneously developed xanthelasma palpebrum.
Biopsy ; Eyelids ; Humans ; Hypolipoproteinemias ; Leprosy ; Leprosy, Lepromatous ; Middle Aged ; Neuralgia ; Peripheral Nerves ; Rifampin ; Skin ; Vitiligo