Department of Internal Medicine, NAUTH, Nnewi, Anambra State, Nigeria.
Department of Histopathology, NAUTH, Nnewi, Anambra State, Nigeria.
Trop Doct. 2024 Oct;54(4):380-382. doi: 10.1177/00494755241263615. Epub 2024 Jul 23.
Histoid leprosy is an uncommon variant of lepromatous leprosy. It poses a diagnostic challenge because of its distinctive clinical and histopathological features. It presents as smooth papules and nodules that rarely ulcerate. We present the case of a 22-year-old Nigerian man with a 2-year history of multiple, dome-shaped papules and nodules on the skin with necrotic centres. General examination showed right axillary lymphadenopathy, non-pitting oedema, foot ulcer, and glove and stocking sensation loss. Despite previous misdiagnoses, histopathological examination showed dermal expansion by histiocytes arranged in a storiform pattern. Slit skin smear yielded abundant bacilli. The patient was started on WHO multidrug treatment, resulting in the improvement of his lesions. This case emphasises the importance of increased awareness of this rare presentation of leprosy.
组织细胞增生性麻风是一种罕见的瘤型麻风变体。由于其独特的临床和组织病理学特征，它带来了诊断上的挑战。它表现为光滑的丘疹和结节，很少溃疡。我们报告了一名 22 岁的尼日利亚男子的病例，他有 2 年的病史，表现为皮肤出现多个圆顶状丘疹和结节，中央有坏死。全身检查显示右侧腋窝淋巴结肿大、非凹陷性水肿、足部溃疡以及手套和袜子感觉丧失。尽管之前有过误诊，但组织病理学检查显示组织细胞呈束状排列，在真皮中扩张。皮肤切片涂片显示大量杆菌。该患者开始接受世界卫生组织的多药治疗，其病变得到改善。本病例强调了提高对这种罕见麻风表现形式的认识的重要性。
