Histoid Leprosy

Umi Rinasari, Sawitri Sawitri, M. Yulianto Listiawan, Cita Rosita Prakoeswa, Indropo Agusni, Rachmat Santoso, Shinzo Izumi

= http://dx.doi.org/10.20473/ijtid.v1i1.3719
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Abstract


Histoid Leprosy is a variant of lepromatous leprosy with characteristic clinical and histopathological features. Usually it is occured in lepromatous patients who relaps after dapsone monotherapy, in those with dapsone resistance , sometimes even after multidrug treatment, or at times, de novo with characteristic clinical and histopathological features. A 36 years old male, originated from Papua, visited to the skin outpatient clinic with translucent shiny nodules on the left elbow and thumb for the last 18 months. The nodules were multiple, painless and firm. There were nasal congestion, tickening of ear lobes and loss of eye brows. Patient did not have any history of previous antileprotic treatment. Routine blood examination was normal. Bacteriological examination of slit skin smear revealed acid-fast bacilli of Bacterial Index 4+ and Morfologic Index 10%. Histopathology of skin suggested lepromatous leprosy of histoid type with characteristic interlacing bundles of spindle shaped cells. Anti-PGL1 antibody (ELISA) revealed high titer of IgM (>5.300 u/ml) and also IgG anti PGL-1 (>5.300 u/ml). Polymerase chain reaction examination test to detect M.leprae was positive and direct sequencing of M.leprae isolate shows no mutation, which means no resistancy to MDT treatment. Treatment with MDTWHO regiment give clinical improvements and the histoid lesions disappered after 3 months treatment.The histoid form of leprosy in this case developed without any prior treatment of anti leprotic drugs ( de novo ). Some theoretical aspects of the patho-mechanism of histoid leprosy are discussed.


Keywords


Histoid Leprosy, lepromatous leprosy, de novo

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References


Brycesen A, Pfalzgraff RE. Leprosy. 3th ed. Edinburg: Churchill

Livingstone; 1990. p. 80–1.

Jopling WH, McDougall AC. Handbook of Leprosy. 5th ed. India: CBS Publis & Dist; 1996. p. 35–6.

Amirudin M. Ilmu Penyakit Kusta. Makasar: Penerbit Hasanuddin University Press; 2003. h. 115–123.

Scollard DM, Adams LB, Gillis TP, Krahenbuhl JL, Truman RW,

Williams DL. The Continuing Challenges of Leprosy. Clinical Microbiology Review. 2006; 19(2): 338–381.

Sehgal VN, Srivastava G, Singh N. Histoid Leprosy: Histopathological Connotations’ Relevance in Contemporary Context. Am J Dermapathol. vol 31. no. 3. 2009. p. 268–271.

Manoharan R, Madhu R, Srinivasan MS. Histoid Hansen-A case report. e-journal of the Indian Society of Teledermatology,2008;Vol2, no. 2. p. 12–16.

Worobec SM. Treatment of leprosy/Hansen’s disease in the early 21st century. Dermatologic Therapy,Vol. 22, 2009. p. 518–37.

Kaur I, Dogra S, De D, Saikia UN. Histoid leprosy: a retrospective study of 40 cases from India. British J of Dermatology 2009 160, pp. 305–310.

Bopp C, Bakos L. The Histoid Variety of Lepromatous Leprosy.

Arch.Derm.Forsch.1975. 252, 1–10.

Nair SP, Moorthy KP, Suprakasan S, Jayapalan S, Mini G. Histoid leprosy-unsual presentation. International J of Dermatology 2006, 45, 433–434.

Annigeri SR, Metgud SC, Patil JR. Lepromatous leprosy of histoid type. Indian J Med Microbiol 2007; 25: 70–1.

Sehgal VN, Aggarwal A, Srivastava G, Sharma N, Sharma

S. Evolution of Histoid Leprosy (de novo) in Lepromatosa

(Multibacillary) Leprosy. International Journal of Dermatology 2005; 44(7). p. 576–78.

Nayar A. Narayanan JS, Job K Charles. Histopathology Study of Early Skin Lession in Leprosy . Archieves of Pathol 1992; 94: 199–204.

Nkinda SJ, Reddy NBB. Skin smears for leprosy. Nilson T, Sparel G. eds.2nd ed. Wurzburg:Germany leprosy relief association 1990. p. 67–71.

Sharma KA. Histopathology of Histoid Leprosy. International

Journal of Leprosy and Other Mycobacterial Diseases, Mar 1997.


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