1/5. mycobacterium ulcerans infection (buruli ulcer): a case report of the disseminated nonulcerative form.The world health organization recognizes mycobacterium ulcerans infection (buruli ulcer) as a reemerging disease. Classically, lesions are indolent, undermined ulcers of the skin. The characteristic histopathologic changes are provoked by a soluble toxin of M ulcerans that is necrotizing and immunosuppressive. After tuberculosis and leprosy, buruli ulcer is the third most common mycobacterial disease in humans. We report buruli ulcer in a patient in benin, West africa, with widespread edema and diffuse induration of approximately one half of the skin of the trunk. There was no ulceration. The tissue studied was a 16-cm portion excised from the center of the large surgical specimen. Histopathologic analysis showed massive contiguous necrosis of the dermis and subcutis in sections of biopsy specimens from the center, at 2-cm intervals in two radii from the center to the periphery, and at 5-cm intervals around the margin. Acid-fast bacilli infiltrated all specimens except at one peripheral site. Samples of the entire surgical specimen taken from seven sites before fixation were polymerase chain reaction and culture positive for M ulcerans. The disseminated nonulcerative form of M ulcerans infection is well known, but is now increasingly frequent in some highly endemic areas, especially in West africa. This patient died within 48 hours postsurgery, but cause of death was not established. The only regularly effective treatment for advanced lesions is surgical excision of all infected tissue. Estimation of the lateral limits of invasion by M ulcerans may help the surgeon establish the optimal extent of excision. Refinement of the basic concept we used and adaptation to preoperative assessment of the limit of bacterial invasion are urgently needed, especially for massive lesions.- - - - - - - - - - ranking = 1keywords = leprosy (Clic here for more details about this article) |
2/5. cytodiagnosis of histoid leprosy.This paper presents cytomorphological features of the histoid variety of lepromatous leprosy. Fine needle aspiration of a lepromatous nodule showed cytological features consistent with those of histoid leprosy. Simultaneously, a biopsy of the nodule was also performed and the case confirmed as histoid leprosy. The advantages of the fine needle aspiration technique are that it is simple, quickly reportable, and less traumatizing. Multiple aspirations from different sites may be obtained, which would add to the value of sampling. The need to differentiate a histoid nodule from a conventional lepromatous nodule is explained.- - - - - - - - - - ranking = 9.7007241438945keywords = leprosy, lepromatous (Clic here for more details about this article) |
3/5. Cutaneous mycobacterium avium intracellulare infection in an hiv patient mimicking histoid leprosy.Cutaneous infections with mycobacterium avium intracellulare (MAI) are uncommon in healthy patients but may arise in those with underlying immunocompromise, including patients with hiv. Their clinical manifestations are protean. We report an AIDS patient with a cutaneous MAI infection that clinically and histopathologically mimicked histoid leprosy, a presentation not previously described in this population.- - - - - - - - - - ranking = 5keywords = leprosy (Clic here for more details about this article) |
4/5. Lucio phenomenon and Lucio leprosy.Lucio phenomenon is a peculiar reactional state associated with Lucio leprosy; both exhibit a restricted global distribution. The exact underlying pathomechanism of Lucio phenomenon, which may be fatal at times, still needs further elaboration. A case of relapse of partially treated nodular lepromatous leprosy presenting with Lucio phenomenon is reported, along with a brief review of the literature.- - - - - - - - - - ranking = 6.9002413812982keywords = leprosy, lepromatous (Clic here for more details about this article) |
5/5. Emergence of leprosy in a patient with mycosis fungoides.A patient with mycosis fungoides that had progressed to tumor stage responded to chemotherapy and electron beam treatment, but 6 years later a peripheral neuropathy, extensive plaques, erythroderma, and enlarged pinnae containing acid-fast organisms developed while he was being treated with photopheresis. The skin lesions cleared with administration of rifampin and dapsone, but a reversal reaction biopsy specimen showed features of both mycosis fungoides and leprosy. This case raises the question of whether there may be an association between mycosis fungoides and leprosy.- - - - - - - - - - ranking = 6keywords = leprosy (Clic here for more details about this article) |