Bharucha Jinai, Saito-Tom Lynne
Department of Obstetrics, Gynecology, & Women's Health, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI, USA.
Case Rep Perinat Med. 2022 Feb 23;11(1):20210046. doi: 10.1515/crpm-2021-0046. eCollection 2022 Jan.
Hansen's disease (HD) often manifests during pregnancy and the postpartum. Patients with HD may experience reactions that mimic other conditions making diagnosis challenging.
We present a case of a patient from Chuuk, a state of the Federated States of Micronesia with a sepsis-like illness and worsening painful rash immediately postpartum. Antepartum, the patient noted a pruritic rash on her legs. Four hours after delivery, the patient became febrile and later developed systemic inflammatory response syndrome (SIRS). The rash rapidly spread to other areas of her body and became painful and edematous. Eight weeks after delivery, a skin biopsy revealed tuberculoid granulomatous dermatitis consistent with HD.
HD and its associated reactions are easily misdiagnosed. Performing a skin biopsy of unusual skin lesions or common skin lesions with severe illness in a pregnant patient can expedite diagnosis of rare conditions such as HD. Early initiation of treatment for HD and its reactions are critical to prevent serious nerve damage and permanent disability.
麻风病（HD）常在孕期及产后出现。HD患者可能会出现类似其他病症的反应，这使得诊断具有挑战性。
我们报告一例来自密克罗尼西亚联邦楚克州的患者，产后立即出现类似败血症的疾病并伴有逐渐加重的疼痛性皮疹。产前，患者注意到腿部有瘙痒性皮疹。分娩后4小时，患者发热，随后发展为全身炎症反应综合征（SIRS）。皮疹迅速蔓延至身体其他部位，变得疼痛且水肿。分娩8周后，皮肤活检显示为与HD一致的结核样肉芽肿性皮炎。
HD及其相关反应容易被误诊。对孕妇出现的不寻常皮肤病变或伴有严重疾病的常见皮肤病变进行皮肤活检，可加快对HD等罕见病症的诊断。尽早开始针对HD及其反应的治疗对于预防严重神经损伤和永久性残疾至关重要。
