Shirasaki Fumiaki, Takehara Kazuhiko, Takata Minoru, Namisato Masako
Kanazawa University Graduate School of Medical Science, Department of Dermatology, 15-1 Takara-machi, Kanazawa 920-8641, Japan.
Nihon Hansenbyo Gakkai Zasshi. 2003 Aug;72(3):267-70. doi: 10.5025/hansen.72.267.
A 68 year-old male presented with painful swelling in the extremities and disseminated small brownish nodules over his entire body. A histological examination of the skin nodules showed multiple granuloma and a thickened peripheral nerve bundle surrounded with foamy macrophages and a few lymphocytes. Fite stain revealed numerous acid fast bacilli within the cytoplasm of the foamy cells. A diagnosis of lepromatous leprosy was thus made and multi-drug therapy following the Japanese guideline with DDS, rifampicin and clofazimine was started. The clinical features improved, and the morphological index decreased after undergoing chemotherapy. Although a severe type 1 reaction developed after four months of treatment, he was treated with oral prednisolone at a dose of 40 mg/day.
一名68岁男性出现四肢疼痛性肿胀,全身散在分布着小的褐色结节。对皮肤结节进行组织学检查显示有多个肉芽肿以及被泡沫状巨噬细胞和少量淋巴细胞环绕的增厚外周神经束。Fite染色显示泡沫细胞胞质内有大量抗酸杆菌。由此诊断为瘤型麻风,并开始按照日本指南采用氨苯砜、利福平及氯法齐明进行多药治疗。化疗后临床症状改善,形态学指数下降。尽管在治疗4个月后出现了严重的1型反应,但给予其口服泼尼松龙,剂量为40毫克/天进行治疗。