Becker D, Bräuninger W
Hautklinik, Johannes-Gutenberg-Universität, Mainz.
Hautarzt. 1994 Dec;45(12):845-8. doi: 10.1007/s001050050183.
Taking into account the increase in worldwide human migration, leprosy is of growing importance in the differential diagnosis of dermatological diseases encountered in Central Europe. We report on the case of a young man from Ghana who developed hypopigmented maculae and plaques on his trunk and proximal limbs. The diagnosis of lepromatous leprosy could be made in consideration of the histological pattern of infiltrating leucocytes and detection of numerous acid-fast mycobacteria on skin biopsy. The results of the physical examination as well as routine laboratory and immunological parameters were consistent with this form of leprosy. Due to glucose-6-phosphate-dehydrogenase deficiency, treatment with dapsone was contraindicated. With high-dose rifampicin and clofazimine therapy, the skin changes cleared over the course of 11 months following a leprosy reaction type II (erythema nodosum leprosum) that developed during a phase of discontinued therapy due to low patient compliance.
考虑到全球范围内人类迁徙的增加，麻风病在中欧皮肤科疾病的鉴别诊断中日益重要。我们报告了一例来自加纳的年轻男子，其躯干和近端肢体出现色素减退斑和斑块。考虑到浸润白细胞的组织学模式以及皮肤活检中发现大量抗酸分枝杆菌，可诊断为瘤型麻风。体格检查结果以及常规实验室和免疫参数与这种麻风病形式一致。由于葡萄糖-6-磷酸脱氢酶缺乏，禁用氨苯砜治疗。在因患者依从性低而中断治疗阶段出现II型麻风反应（结节性红斑麻风）后，采用高剂量利福平和氯法齐明治疗，皮肤病变在11个月内消退。
