Wade histoid leprosy revisited.
An 18-year-old man presented with a 4-year history of erythematous patches on the trunk, followed 2-years later by multiple nodules, mostly located on the limbs, and distal paresthesias. Two close contacts were treated for leprosy during his childhood. Histopathological examination revealed a histiocytic infiltrate with acid-fast bacilli on Ziehl-Neelsen stain. The slit-skin and nasal smears showed numerous acid-fast bacilli. The correlation between clinical, epidemiological, histopathological, and microbiological features allowed the diagnosis of lepromatous leprosy, histoid variant. Multidrug therapy as recommended by the WHO was initiated. A rapid and sustained improvement was seen. Histoid leprosy is a rare manifestation of lepromatous leprosy, first described by Wade in 1960. Since then few cases have been reported, the majority of them from countries with a high prevalence of the disease. Early recognition and treatment are of most importance to prevent neurological disabilities and achieve epidemiological control.
Hospital de Santo António dos Capuchos - Centro Hospitalar de Lisboa Central, Lisboa. virginiacoelhodesousa@gmail.com.
Virginia
V
Coelho de Sousa
Andre
A
Laureano
Jorge
J
Cardoso
D000293:Adolescent; D002991:Clofazimine / Q000627:therapeutic use; D003622:Dapsone / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D007917:Leprostatic Agents / Q000627:therapeutic use*; D015440:Leprosy, Lepromatous / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D012293:Rifampin / Q000627:therapeutic use
D007917:Leprostatic Agents; D003622:Dapsone; D002991:Clofazimine; D012293:Rifampin