Verma Rajesh, Vasudevan Biju, Pragasam Vijendran, Moorchung Nikhil, Mitra Debdeep, Gopal Manoj
Lepr Rev. 2015 Mar;86(1):96-101.
A 30 year old woman who presented with multiple numb patches on the body was initially diagnosed as borderline lepromatous leprosy and started on multidrug therapy for leprosy. She had an episode of Type 1 reaction during the fifth month of pregnancy. After delivery, she stopped therapy fearing harm to her child and developed an episode of Type 2 reaction. The reaction was unusual in that bullous lesions developed over previous leprosy patches which had initially become indurated, with associated neuritis. Histopathology revealed bullae with intense neutrophilic reaction and strong positivity for acid fast bacilli. There was no response to steroid therapy which was started for the reaction. Thalidomide had to be prescribed after stopping lactation by medical means. She responded dramatically to Thalidomide with regression of cutaneous lesions and neuritis. This patient is being reported as a very unusual manifestation of bullous erythema nodosum leprosum in the postpartum period responding dramatically to thalidomide.
一名30岁女性，身上出现多处麻木斑块，最初被诊断为界线类偏瘤型麻风，并开始接受麻风病联合化疗。她在怀孕第五个月时发生了一次1型反应。分娩后，她因担心对孩子有害而停止治疗，随后发生了一次2型反应。此次反应不同寻常之处在于，先前已硬结的麻风病斑块上出现了大疱性损害，并伴有神经炎。组织病理学显示大疱伴有强烈的中性粒细胞反应，抗酸杆菌呈强阳性。针对此次反应开始使用的类固醇治疗无效。在通过医学手段停止哺乳后，不得不使用沙利度胺。她对沙利度胺反应显著，皮肤损害和神经炎消退。本文报告了该患者产后出现的一种非常罕见的大疱性结节性红斑麻风表现，对沙利度胺反应显著。
