title: Epithelioid granuloma in the iris of a lepromatous leprosy patient; an unusual finding.
abstract: This case report depicts a case of histopathologically confirmed polar lepromatous (LL) leprosy with a bacterial index of 4+. He experienced recurrent episodes of erythema nodosum leprosum (ENL) in the first 5 years after diagnosis. Skin smears became negative after 6 years of dapsone monotherapy and have remained negative since that time. At 23 years after diagnosis, the patient had developed cataracts and underwent intracapsular cataract extractions with broad-based iridectomies. In one of the iris specimens, histopathologic examination revealed a focal granuloma composed of epithelioid cells. Subsequently a lepromin skin test showed a positive Mitsuda reaction with a borderline tuberculoid histopathology. This clearly illustrates the immunological upgrading of a polar lepromatous patient, perceived first in the iris tissue.
authors.affiliation: Department of Ophthalmology, Schieffelin Leprosy Research and Training Center, Karigiri, Tamil Nadu, India.
authors.forename: E
authors.initials: E
authors.lastname: Daniel
authors.forename: G J
authors.initials: GJ
authors.lastname: Ebenezer
authors.forename: T J
authors.initials: TJ
authors.lastname: ffytche
authors.forename: A
authors.initials: A
authors.lastname: Sigamani
authors.forename: C K
authors.initials: CK
authors.lastname: Job
mesh_terms: D000328:Adult; D004893:Erythema Nodosum / Q000150:complications* / Q000473:pathology; D006801:Humans; D015863:Iridocyclitis / Q000150:complications* / Q000473:pathology; D015440:Leprosy, Lepromatous / Q000150:complications* / Q000473:pathology; D008297:Male