title: Generalized granulomatous dermatitis following Mycobacterium w (Mw) immunotherapy in lepromatous leprosy.
abstract: Mycobacterium w (Mw) vaccine is a heat-killed suspension derived from a nonpathogenic, cultivable, atypical mycobacterium named Mycobacterium indicus pranii. Mw immunotherapy has been reported to be efficacious as an adjunct to multidrug therapy multibacillary regimen in leprosy patients with high bacillary index. Cutaneous reactions are predominant adverse effects associated with the administration of vaccines. Cutaneous adverse effects ascribed to Mw vaccine are generally limited to the site of injection. We herein describe two cases of lepromatous leprosy who developed an unusual generalized cutaneous reaction following Mw immunotherapy. A high index of suspicion is needed to identify such manifestations in leprosy cases to avoid misdiagnosis of a relapse or a reaction and for appropriate treatment.
authors.affiliation: Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Geeti
authors.initials: G
authors.lastname: Khullar
authors.affiliation: Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Narang
authors.affiliation: Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Uma
authors.initials: U
authors.lastname: Nahar Saikia
authors.affiliation: Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Dogra
mesh_terms: D000328:Adult; D001428:Bacterial Vaccines / Q000009:adverse effects*; D001706:Biopsy; D003872:Dermatitis / Q000175:diagnosis / Q000382:microbiology*; D006099:Granuloma / Q000175:diagnosis / Q000382:microbiology*; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects* / Q000379:methods; D015440:Leprosy, Lepromatous / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000382:microbiology*; D012867:Skin / Q000382:microbiology* / Q000473:pathology; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000382:microbiology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001428:Bacterial Vaccines; C080550:Mycobacterium w vaccine
keywords: Mw vaccine; Mycobacterium indicus pranii; granulomatous dermatitis; immunotherapy; leprosy; mycobacteria