Cases reported "Leprosy, Borderline"

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1/59. Locally acquired Hansen's disease in north queensland.

    Hansen's disease (leprosy) is rare in australia and usually imported from endemic areas. We report a 23-year-old white male with multibacillary leprosy who had lived all his life in North queensland and initially appeared to have no risk factors. However, historical records revealed his grandfather to have been infected; because of stigma, this was unknown to the patient. As Hansen's disease has an incubation period of years, isolated cases may still occur as a result of previous endemicity in queensland.
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ranking = 1
keywords = leprosy
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2/59. facial nerve pathology in leprosy: searching for the proximal extent of the lesion in facial nerve biopsies.

    A light and electron microscope study was made of resin embedded facial nerves in three cases of leprosy involving the facial nerve. The patients had irreversible facial nerve palsies and had requested facial reconstruction. No consistent pattern of nerve fibre damage was found. In one case the temporozygomatic was affected, but the cervical branch was normal, suggesting the damage begins distally. In two cases the loss of nerve fibres in the trunk and all branches was similar, and is likely to emanate from damage at a more proximal site. The presence of increased numbers of unmyelinated axons, often in clusters, is evidence of regeneration. These axons probably have the potential to develop into functional myelinated fibres provided that they can innervate a viable distal target such as a muscle graft. These regenerating axons are distal to the stylomastoid foramen suggesting that the most proximal level of involvement of the facial nerve could be intracranial. The finding of a more proximal level of nerve involvement, implies that the mis-reinnervation seen in partially recovered facial nerve palsies in leprosy, could be due to some regenerating axons being mis-directed at the level of the main trunk bifurcation.
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ranking = 3
keywords = leprosy
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3/59. A recurrent case of BT leprosy with widely spread skin lesions showing a histopathology of indeterminate group after 4.5-years irregular treatment, bangladesh.

    A 29 year-old Bengali male case is presented in this paper which was a borderline tuberculoid leprosy (BT) at detection. His father contracted a lepromatous leprosy of G = 2 deformity. He took anti-leprosy drugs including MDT/MB regimen irregularly and had maculae widely-spread with anesthesia 16 months after being released from treatment (RFT). The histopathology of the maculae unexpectedly showed that of an indeterminate group of leprosy. The recurrent skin lesions were susceptive to a four-week regimen of Rifampicin and ofloxacin. This case can not be defined as a relapsed case, because slit skin smears were always negative. It would be called a recurrent case after MDT/MB regimen. Though the reason recurrent skin lesions occur is unknown, it is reasonable to assume that the recurrent lesions are caused by dormant persisters which are originally drug sensitive. The recurrent skin lesions can not be classified because the clinical features can not be matched to their histology. Such recurrent cases might occur among the defaulters of MDT in future.
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ranking = 4
keywords = leprosy
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4/59. Generalized annular borderline tuberculoid leprosy and update in management of Hansen's disease.

    We describe a patient with widespread borderline tuberculoid leprosy and significant peripheral nerve involvement. Despite the presence of widespread lesions, Fite stains and polymerase chain reaction studies were initially negative. We discuss the diagnosis and treatment of leprosy including recent changes in treatment regimens and duration.
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ranking = 3
keywords = leprosy
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5/59. Borderline tuberculoid leprosy of the scalp.

    A case of borderline tuberculoid leprosy involving the hairy scalp is reported. To the best of our knowledge, only two paucibacillary leprosy patients with scalp lesion have been reported, and in only one was the scalp covered with hair.
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ranking = 3
keywords = leprosy
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6/59. leprosy lesion on the prepuce of the male genitalia: a case report.

    A case of borderline leprosy in type I reaction with cutaneous lesions on the prepuce is reported. The need to examine the genitalia in all male leprosy patients is stressed.
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ranking = 1
keywords = leprosy
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7/59. Prostate cancer in patients with Hansen's disease.

    Hansen's disease causes testicular failure secondarily, and because of this, it has been considered that prostate cancer would not be found in association. Three of 14 patients with chronic leprosy in Suruga National Sanatorium Hansen's Disease Hospital were found to have prostate cancer. A 72-year-old with lepromatous leprosy was diagnosed with stage T3a prostate cancer and treated with radical prostatectomy after hormonal therapy, plus irradiation. An 80-year-old with lepromatous leprosy was diagnosed with stage T2 prostate cancer and treated with irradiation and follow up only without hormone therapy and surgery because of his low testosterone level and old age. An 82-year-old with borderline leprosy was diagnosed with stage T1c prostate cancer and because of the pathological finding of low Gleason score and his old age, he was treated with hormonal therapy only. Two of the three cases had elevated concentrations of follicle-stimulating hormone and luteinizing hormone, which suggests that their prostatic cancers might have been equivalent to be under the influence of hormone therapy. Therefore, in aged male patients with Hansen's disease, the follicle-stimulating hormone, luteinizing hormone and testosterone concentrations should be measured, as well as that of prostate-specific antigen, and a prostate biopsy should be also considered if the prostate-specific antigen concentration is increased, even with hypogonadism.
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ranking = 2
keywords = leprosy
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8/59. Location of the extracranial extent of leprous facial nerve pathology may allow leprous facial palsy to be reanimated by free muscle transfer.

    leprosy is a mycobacterial nerve and skin infection, which can be eradicated by antibiotics. Some patients affected by leprosy, once cured, have residual nerve impairment with paralysis and sensory neuropathy. A series of patients with facial nerve paralysis, investigated using clinical, histological and electrophysiological techniques, demonstrated that the nerve pathology was distal to the section of main trunk prior to its bifurcation. Facial reanimation was achieved with a free gracilis-muscle transfer, coapting its motor nerve to the ipsilateral facial nerve trunk proximal to the site of the leprosy pathology, with a moderate clinical result.
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ranking = 1
keywords = leprosy
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9/59. A case report of fatal dapsone-induced agranulocytosis in an Indian mid-borderline leprosy patient.

    Fatal agranulocytosis in an Indian male receiving 100mg of dapsone daily, hospitalized for mid-borderline leprosy in type I reaction with triple nerve paralysis is reported. Various case reports concerning dapsone-induced agranulocytosis are reviewed.
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ranking = 2.5
keywords = leprosy
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10/59. leprosy in a Mexican immigrant.

    A new diagnosis of borderline lepromatous leprosy was established in a man who had immigrated to kentucky from mexico. He was placed on a world health organization treatment regimen consisting of dapsone, clofazimine, and rifampin. The biology of leprosy, its diagnosis, treatment, and worldwide impact are reviewed. Because of the potential for highly mobile populations to export endemic diseases, kentucky physicians must expand their lists of differential diagnoses.
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ranking = 1
keywords = leprosy
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