Leprosy Mailing List – July 4, 2018
Ref.: (LML) Neural Leprosy and Rheumatoid Arthritis
From: Zhaudat Umerov, Moscow, Russia
Dear Dr Schreuder,
Thank Dr. Tahir for the mail (LML, June 28, 2018). Neural Leprosy and Rheumatoid Arthritis.
The lady's clinical signs: "...multiple nerve enlargements, nerve tenderness and loss of nerve function of both motor and sensory nerves ..." are base for diagnosis of pure neurotic leprosy. Often the loss of sensitivity is the cause of burns and scars and spots on the skin, but "…She never had any obvious skin lesion suggestive of Leprosy". Beyond that, absence causative pathogen in nasal mucosa smears and skin biopsy during pregnant and reaction Type 1 indicates that the initial diagnosis of PN Leprosy are questioned. After MDT, she had a long time clinical stability without exacerbations, reactions and spread of nerve function impairment. Eight years later she presented Swan neck deformities and wrist involvement without atrophy of muscles and bone tissue (characteristic for leprosy deformities). All the clues together indicate that the lady apparently has no leprosy.
I agree with Dr Willem J.Theuvenet and also advise her to consult by a rheumatologist and neurologist.
Best regards,
Zhaudat Umerov
Dermatologist/Leprologist, Leprosy Research Institute. The Russian Federation
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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