Leprosy Mailing List – October 14, 2024
Ref.: (LML) 2024 winners Alliance Against Leprosy Prize"Case reports in leprosy - shared practice"
From: Laila de Laguiche, Curitiba, Brazil
Dear Pieter,
As you know, the Alliance Against Leprosy ( AAL), together with the journal Hansenologia Internationalis: Leprosy and Other Infectious Diseases (HI), is promoting a special section in the HI journal entitled "Case reports in leprosy - shared practice", offering an annual prize to the three reports that obtain the best scores.
We are pleased to announce the 2024 winners and the editorial team share the understanding that scientific dissemination on leprosy through clinical case reports represents an opportunity to promote the rapid spread of knowledge.
We congratulate the winners and look forward to more articles, always stimulating!
Best regards,
Laila
Curitiba - Brazil
- 1º :
Ulcerative type 1 lepra reaction in borderline tuberculoid leprosy: A rare presentation;
Autor: Sabha Mushtaq
https://periodicos.saude.sp.gov.br/hansenologia/article/view/40191/38202
ABSTRACT
Introduction:
leprosy is a chronic infectious disease caused by Mycobacterium leprae, characterized by a wide spectrum of clinical presentations. In India, borderline-tuberculoid leprosy is the most common form encountered in clinical practice.
Type 1 lepra reaction in borderline-tuberculoid leprosy usually presents as the development of erythema and/or edema in pre-existing skin lesions.
Ulceration of skin lesions in type 1 lepra reaction is uncommon and occurs in severe reactions. Objective: to report an unusual presentation of borderline-tuberculoid leprosy with ulcerative type 1 lepra reaction in an immunocompetent patient.
Case description:
We present the case of a 65-year old man with chief complaints of ulcerated plaque over his left thigh. He also had other skin lesions suggestive of borderline-tuberculoid leprosy over his trunk and limbs, as well as enlarged, mildly tender left ulnar and lateral popliteal nerves. A slit skin smear was negative, while a skin biopsy supported the diagnosis of borderline-tuberculoid leprosy. The patient responded to multibacillary multidrug therapy according recommended by World Health Organization and tapering doses of prednisolone, with complete healing of the ulceration at six weeks follow-up.
Discussion:
Type 1 lepra reaction associated with borderline-tuberculoid leprosy usually presents with increased erythema and edema in pre-existing skin lesions. Ulceration in such skin lesions is not commonly seen except in cases with severe type 1 leprosy reactions. Administration of oral corticosteroids along with multibacillary multidrug therapy is the key to managing ulcerative type 1 lepra reaction. The ulceration heals rapidly with tapering doses of oral corticosteroids, limiting the duration of morbidity.
Final consideration:
The case emphasizes the need for dermatologists and leprologists to be aware of atypical presentations of leprosy reactions, ensuring timely diagnosis and effective management to achieve optimal patient outcomes.
- 2º :
Concomitance of lepromatous leprosy and squamous cell carcinoma: case report;
Autors: Hugo Hatanaka, Bruno de Carvalho Dornelas, Pauline Dias Soares Girardi, Caio Oliveira Sena, Marcelo Campos Rocha, Isabela Maria Bernardes Goulart
https://periodicos.saude.sp.gov.br/hansenologia/article/view/40198/38198
ABSTRACT
Introduction:
Leprosy is an endemic disease in Brazil, ranking second worldwide for the number of new cases diagnosed yearly. However, late diagnosis of this disease is still common. Objective: to alert health professionals to the importance of recognizing the insidious signs of leprosy, both clinical and histopathological, even in the presence of other, more apparent alterations.
Presentation and discussion of the case:
A man with skin lesions suggestive of squamous cell carcinoma.
On histological examination, besides the carcinoma, there were aggregates of foamy macrophages full of acid-fast bacilli compatible with lepromatous leprosy. A more detailed physical examination by a multidisciplinary team from a national reference center also revealed skin with a diffuse infiltrated appearance and supraciliary madarosis, alterations not noticed in the first evaluation at another service.
Final considerations: this case can help clinical professionals and pathologists pay attention to skin alterations that can make it challenging to diagnose leprosy, especially in endemic regions, to enable early diagnosis and reduce the disabilities related to the disease.
- 3º :
Quantitative PCR diagnostic value in monitoring a patient with leprosy: case report
Autors: Marcos Daniel Silva Pinheiro, Maisa Pereira Vieira, Daisy Cristina Monteiro dos Santos, Alexandre Castelo Branco, Lorena Bruna Pereira de Oliveira, Lucia Alves de Oliveira Fraga.
https://periodicos.saude.sp.gov.br/hansenologia/article/view/40201/38180
ABSTRACT
Introduction:
Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae. Objective: the study aims to report the follow-up of a patient with leprosy, presenting a positive quantitative polymerase chain reaction (qPCR).
Case description:
The patient is a 53-year-old male residing in the rural area of São Geraldo da Piedade, Minas Gerais State, Brazil.
In 2015, the patient sought care at the Governador Valadares Municipal Central Polyclinic and was referred to the Dr. Alexandre Castelo Branco Reference Center for Endemic Diseases and Special Programs (CREDEN-PES) to initiate treatment. However, he did not adhere to the therapy, citing difficulty accessing the center.
In 2017, he returned to CREDEN-PES, where he was examined and collected material for bacilloscopy and qPCR. The bacilloscopy index (BI) result was zero and positive for qPCR. The patient was referred for treatment in his hometown and adhered to two doses of multibacillary multidrug therapy (MB-MDT).
In 2021, he sought CREDEN-PES for new evaluations, resulting in BI = 1.5 and decreased plantar sensitivity.
He began a unique treatment regimen for leprosy (U-MDT).
In 2023, he moved to Paraná State and recently reported his condition: regular health, altered balance, frequent falls, loss of strength in the knees, dry skin, and swelling behind the ear. The positivity of the qPCR reaction prompted the team to follow up with this patient, who initially did not adhere to the treatment.
Conclusion:
It is believed that using laboratory tools to assist and reinforce the diagnosis and treatment has contributed to more effective leprosy control
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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