Horta-Baas G, Hernández-Cabrera M F, Barile-Fabris L A, Romero-Figueroa M del S, Arenas-Guzmán R
Servicio de Reumatología, Hospital General Regional 220, Instituto Mexicano del Seguro Social, Toluca, Estado de México, México
Centro de Investigación en Ciencias Médicas, Universidad Autónoma del Estado de México, Toluca, Estado de México, México.
Lupus. 2015 Sep;24(10):1095-102. doi: 10.1177/0961203315574557. Epub 2015 Mar 10.
Leprosy is an infectious chronic disease with a wide range of clinical and serological manifestations. We report a case of a woman presenting with a malar rash, painless oral ulcers, photosensitivity, arthritis, positive antinuclear antibodies test and leuko-lymphopenia. Our case illustrates an unusual presentation of leprosy initially diagnosed as systemic lupus erythematosus (SLE). After the confirmation of multibacillary leprosy and multidrug therapy recommended by the World Health Organization, a good clinical response was observed. Recognition of rheumatic manifestations in leprosy is important as they may be confused with SLE. A literature review is presented to encourage clinicians to consider leprosy as a differential diagnosis. Specifically in patients with unusual rheumatic manifestations and persistent skin lesions, and when neurological symptoms are present. Leprosy has not been eradicated, so misdiagnosis can be frequent. It is necessary to increase medical practitioner awareness in order start proper treatment.
麻风病是一种具有广泛临床和血清学表现的传染性慢性病。我们报告一例女性病例，该患者出现面颊部皮疹、无痛性口腔溃疡、光敏性、关节炎、抗核抗体检测阳性及白细胞淋巴细胞减少。我们的病例说明了麻风病一种不寻常的表现，最初被诊断为系统性红斑狼疮（SLE）。在确诊为多菌型麻风病并采用世界卫生组织推荐的多药联合治疗后，观察到了良好的临床反应。认识麻风病的风湿性表现很重要，因为它们可能与SLE相混淆。本文进行文献综述以鼓励临床医生将麻风病作为鉴别诊断考虑。特别是对于有不寻常风湿性表现和持续性皮肤病变的患者，以及出现神经症状时。麻风病尚未根除，因此误诊很常见。有必要提高执业医生的认识以便开始适当治疗。
