title: A recurrent case of BT leprosy with widely spread skin lesions showing a histopathology of indeterminate group after 4.5-years irregular treatment, Bangladesh.
abstract: A 29 year-old Bengali male case is presented in this paper which was a borderline tuberculoid leprosy (BT) at detection. His father contracted a lepromatous leprosy of G = 2 deformity. He took anti-leprosy drugs including MDT/MB regimen irregularly and had maculae widely-spread with anesthesia 16 months after being released from treatment (RFT). The histopathology of the maculae unexpectedly showed that of an indeterminate group of leprosy. The recurrent skin lesions were susceptive to a four-week regimen of Rifampicin and Ofloxacin. This case can not be defined as a relapsed case, because slit skin smears were always negative. It would be called a recurrent case after MDT/MB regimen. Though the reason recurrent skin lesions occur is unknown, it is reasonable to assume that the recurrent lesions are caused by dormant persisters which are originally drug sensitive. The recurrent skin lesions can not be classified because the clinical features can not be matched to their histology. Such recurrent cases might occur among the defaulters of MDT in future.
authors.affiliation: PIME Sisters Khulna Leprosy Program, Boro Boyra, Khulna, Bangladesh. yutakashida@bea.hi-ho.ne.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Ishida
authors.forename: M
authors.initials: M
authors.lastname: Ozaki
authors.forename: L
authors.initials: L
authors.lastname: Picorini
authors.forename: E
authors.initials: E
authors.lastname: Guglielmelli
mesh_terms: D000328:Adult; D001459:Bangladesh; D004359:Drug Therapy, Combination; D006801:Humans; D007917:Leprostatic Agents / Q000008:administration & dosage; D015439:Leprosy, Borderline / Q000188:drug therapy / Q000473:pathology*; D015441:Leprosy, Tuberculoid / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D015242:Ofloxacin / Q000008:administration & dosage; D012008:Recurrence; D012293:Rifampin / Q000008:administration & dosage; D012867:Skin / Q000473:pathology*; D013997:Time Factors; D016896:Treatment Outcome; D016312:Treatment Refusal
chemical_list: D007917:Leprostatic Agents; D015242:Ofloxacin; D012293:Rifampin