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麻风合并硬皮病和白内障:临床难题

Leprosy Presenting With Scleroderma and Cataract: A Clinical Conundrum.

作者信息

Ahmed Sana, Patel Maharshi, Chakole Swarupa, Choudhari Sonali

机构信息

Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Jul 16;16(7):e64698. doi: 10.7759/cureus.64698. eCollection 2024 Jul.

DOI:10.7759/cureus.64698
PMID:39156458
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11329340/
Abstract

Leprosy, a chronic infectious disease caused by , even though treatable, remains a significant public health problem. It mainly impacts the skin, peripheral nerves, mucosa of the upper respiratory tract, and the eyes. In this case report, we present the case of a 64-year-old female with numerous hypopigmented patches with loss of sensations, madarosis, resorption of toes and digits, skin tightening, and diminution of vision. The skin over the hands exhibited thickening, leading to functional impairments that influenced both manual dexterity and mobility. The diagnosis of this unique case, showing a complex triad of lepromatous leprosy, scleroderma, and sclerotic cataract, was confirmed by clinical evaluation, skin biopsies, serological tests, and ophthalmic examination. Following this, the patient underwent dexamethasone-cyclophosphamide pulse therapy and multidrug treatment to halt the disease progression, prevent further disability, and reduce transmission. The case management addressed the issue of overlapping symptoms and conditions to provide appropriate care and cure to the patient. Public health initiatives under the National Leprosy Eradication Programme play an important role in promoting early diagnosis, effective treatment, and community empowerment, working toward a future where leprosy is no longer a threat to public health by preventing disability, reducing transmission, and combating the social stigma associated with it.

摘要

麻风病是一种由……引起的慢性传染病,尽管可治,但仍是一个重大的公共卫生问题。它主要影响皮肤、周围神经、上呼吸道黏膜和眼睛。在本病例报告中,我们呈现了一名64岁女性的病例,她有多处色素减退斑且感觉丧失、睫毛脱落、脚趾和手指吸收、皮肤紧绷以及视力减退。手部皮肤增厚,导致功能障碍,影响了手部灵活性和活动能力。通过临床评估、皮肤活检、血清学检测和眼科检查,确诊了这一独特病例,该病例表现为瘤型麻风、硬皮病和硬性白内障的复杂三联征。此后,患者接受了地塞米松 - 环磷酰胺脉冲疗法和联合化疗,以阻止疾病进展、预防进一步残疾并减少传播。病例管理解决了症状和病情重叠的问题,为患者提供适当的护理和治疗。国家麻风病消除计划下的公共卫生举措在促进早期诊断、有效治疗和社区赋权方面发挥着重要作用,致力于实现一个麻风病不再对公共卫生构成威胁的未来,通过预防残疾、减少传播以及消除与之相关的社会耻辱感来达成这一目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eda/11329340/f3c99cc85d0a/cureus-0016-00000064698-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eda/11329340/fcd88724d154/cureus-0016-00000064698-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eda/11329340/f3f2fe0be2e9/cureus-0016-00000064698-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eda/11329340/af4a64c58e98/cureus-0016-00000064698-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eda/11329340/be01d92f8f82/cureus-0016-00000064698-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eda/11329340/f3c99cc85d0a/cureus-0016-00000064698-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eda/11329340/fcd88724d154/cureus-0016-00000064698-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eda/11329340/f3f2fe0be2e9/cureus-0016-00000064698-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eda/11329340/af4a64c58e98/cureus-0016-00000064698-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eda/11329340/be01d92f8f82/cureus-0016-00000064698-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eda/11329340/f3c99cc85d0a/cureus-0016-00000064698-i05.jpg

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本文引用的文献

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A study on the multidisciplinary diagnostic approach of leprosy: Can we prevent the recrudescence in the post-elimination Indian scenario?麻风病多学科诊断方法的研究:在印度消除麻风病后的情况下,我们能否预防复发?
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PLoS Negl Trop Dis. 2022 Mar 17;16(3):e0010201. doi: 10.1371/journal.pntd.0010201. eCollection 2022 Mar.
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Advances in pathogenesis and treatment of systemic sclerosis.系统性硬化症的发病机制与治疗进展
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Leprosy in post-elimination era in India: difficult journey ahead.印度消除麻风病后的时代:前路艰难。
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Clinicohistopathological correlation in leprosy.麻风病的临床组织病理学相关性
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