Vora Rita V, Pilani Abhishek
Department of Skin and VD, Pramukhswami Medical College, Karamsad, Anand, Gujarat, India.
Indian Dermatol Online J. 2014 Oct;5(4):504-7. doi: 10.4103/2229-5178.142522.
Histoid leprosy is a rare form of multibacillary leprosy with distinct clinical and histopathological features. It is a variant of lepromatous leprosy with a very high bacillary load. It appears in patients as relapse after dapsone monotherapy and resistance or rarely, "de novo." Although leprosy is slowly declining the exact mode of transmission is unclear. At least until recently, the most widely held belief was that the disease was transmitted by contact between cases of leprosy and healthy persons. Transmission by the respiratory route is also gaining ground. There are other possibilities such as transmission through insects, which cannot be completely ruled out. However, the present case report possibly suggests the role of skin as a portal of both exit and entry for the bacillus in histoid leprosy transmission. De novo form of histoid leprosy has numerous solid staining bacteria inside the epidermis. The reports show that these bacilli can be eliminated from the intact epidermis, which indicate an unusual role of the skin in the transmission of leprosy.
组织样麻风是一种罕见的多菌型麻风，具有独特的临床和组织病理学特征。它是瘤型麻风的一种变体，菌量非常高。它在患者中表现为氨苯砜单药治疗后的复发和耐药，或很少见的“初发”情况。尽管麻风发病率在缓慢下降，但其确切传播方式尚不清楚。至少直到最近，最广泛的观点认为该病是通过麻风患者与健康人之间的接触传播的。呼吸道传播也越来越受到认可。还有其他可能性，如通过昆虫传播，这也不能完全排除。然而，本病例报告可能提示皮肤在组织样麻风传播中作为杆菌进出门户的作用。初发形式的组织样麻风在表皮内有大量强嗜银染色细菌。报告显示这些杆菌可从完整的表皮中清除，这表明皮肤在麻风传播中具有不同寻常的作用。
