Leprosy Mailing List, November 7th, 2008
Ref.: Histoid leprosy and Granuloma fraction
From: Faber W. R., Amsterdam, The Netherlands
Dear Dr Ranawaka,
I refer to your LML message dated Oct. 31st, 2008. That is an interesting observation of a patient developing histoid lesions during treatment.
Recently, we treated a patient diagnosed with borderline lepromatous (BL) leprosy who besides the typical BL lesions also had scattered nodular lesions on the extremities: shown by histopathology to be histoid leprosy. As there was a high bacteriological index (BI) we treated him with a long course of multi-drug therapy (MDT). Due to poor compliance we could not definitely state the duration of treatment but we calculated it to be around 24 months. At that time the histoid lesions had flattened, and the BI of the skin biopsy was zero. In this case treatment with standard MDT for around 24 months was effective in curing his (histoid) leprosy.
I would advise you to take biopsies to monitor the result of your treatment by means of BI and Granuloma Fraction *.
With kind regards,
William R. Faber, MD, PhD
Professor of Tropical Dermatology
Academic Medical Center
University of Amsterdam
Meibergdreef 9
1105 AZ Amsterdam
The Netherlands
F: 31 - 20 696 0076
email: w.r.faberatamc.uva.nl
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