Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Chin Med J (Engl). 2012 Feb;125(3):558-60.
Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae, which primarily affects the skin and peripheral nerves. In this article, we present a 45-year-old man and a 39-year-old women who suffered from asymptomatic irregular erythemas on their trunk and extremities. Since both patients denied the history of exposure to leprosy patients and were absent clinical signs of superficial sensation dysfunction and enlarged peripheral nerves, they were diagnosed of mycosis fungoides and livedo reticularis clinically. Nevertheless the biopsies of erythemas showed perineural and periadnexal foamy-cell granulomas in the dermis and Fite staining revealed a large number of acid-fast bacilli. A diagnosis of multibacillary leprosy was made finally. These cases revealed that since leprosy is still epidemic in some remote area in China and in other developing countries and its clinical manifestations may be very weird sometimes, the dermatologists should be alert of it and skin biopsy could confirm the diagnosis.
麻风是一种由麻风分枝杆菌引起的慢性肉芽肿性感染，主要影响皮肤和外周神经。本文报道了 2 例 45 岁男性和 39 岁女性患者，他们的躯干和四肢出现无症状的不规则红斑。由于这 2 例患者均否认接触过麻风患者，且无浅感觉功能障碍和外周神经肿大的临床体征，故临床诊断为蕈样肉芽肿和网状青斑。然而，红斑活检显示真皮内神经和附属器周围泡沫状细胞肉芽肿，Fite 染色显示大量抗酸杆菌。最终诊断为多菌型麻风。这些病例表明，由于麻风在中国一些偏远地区和其他发展中国家仍有流行，且其临床表现有时非常奇特，皮肤科医生应保持警惕，皮肤活检可确诊。
