Giam Y C, Seow C S
Middle Road Hospital, Singapore.
Ann Acad Med Singap. 1987 Oct;16(4):655-7.
Histoid leprosy is a rare variant of lepromatous leprosy. This is the first documented case of histoid leprosy in Singapore. The patient was diagnosed as borderline leprosy in 1973, remained untreated and progressed to lepromatous leprosy. The characteristic histoid lesions were firm pruriginous nodules on the dorsum of his feet. The histology showed a pseudocapsulated tumour with fibroblasts and histiocytes filled with lepra bacilli. Electron microscopy showed fibroblasts, macrophages with bacilli and plasmacytoid cells with active endoplasmic reticulum. He was found to be dapsone-resistant and the lesions cleared with clorphazimine. Immunological defects were not detected.
组织样麻风是瘤型麻风的一种罕见变种。这是新加坡首例有记录的组织样麻风病例。该患者于1973年被诊断为界线类麻风，未经治疗，病情进展为瘤型麻风。其特征性的组织样损害为足部背侧坚实的瘙痒性结节。组织学检查显示为一个假包膜肿瘤，有成纤维细胞和充满麻风杆菌的组织细胞。电子显微镜检查显示有成纤维细胞、含杆菌的巨噬细胞以及内质网活跃的浆细胞样细胞。发现他对氨苯砜耐药，而皮损用氯法齐明清除。未检测到免疫缺陷。
