Cases reported "Leprosy, Tuberculoid"

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1/5. Leprosy in a backpacker.

    Leprosy is the most common cause of peripheral neuropathy in the developing world. It is not expected to be acquired by visitors traveling through these countries. We present a backpacker who contracted leprosy during brief stays in endemic countries.
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2/5. Leprosy & gangrene: a rare association; role of anti phospholipid antibodies.

    BACKGROUND: Leprosy still remains an important public health problem for many parts of the world. An association of gangrene with leprosy is a rare one & can have a number of causative mechanisms. We present a case with Leprosy & gangrene with positive anti phopholipid antibody titers. CASE PRESENTATION: A 50-year-old non-diabetic, non-hypertensive lady presented with 2 months history of progressive gangrene of bilateral toes. She was found to have madarosis & hypopigmented, hypoaesthetic macular lesions on the upper limb & thighs. Bilateral ulnar & popliteal nerves were thickened. A skin biopsy of the lesions revealed borderline tuberculoid leprosy, slit skin smears revealed a bacteriological index of 1 . She did not have any evidence of thromboembolic episode or atherosclerosis. ACLA was positive at presentation & also on another occasion 6 weeks later. ACLAs were of the IgM type on both occasions. Lupus Anticoagulant & beta2 GPI antibody were negative. DOPPLER of the lower limb arteries did not reveal any abnormality. Patient was successfully treated with multi-drug antileprotics & anticoagulants. CONCLUSION: Infectious APLAs should be recognized as a cause of thrombosis in Leprosy. Appropriate anticoagulation can salvage limb function.
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3/5. Scar leishmaniasis.

    A large spectrum of clinical presentations of cutaneous leishmaniasis (CL) have been reported including a scar presentation in many chronic cases. We report here a case where CL developed in a scar of healed lesion of tuberculoid leprosy. Initially, it was suspected as a relapse or reaction of the previous disease, but on histopathology, it proved to be a new disease (CL). On anti-leishmaniasis treatment, lesion healed satisfactorily in about a month time.
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4/5. Ocular involvement in tuberculoid leprosy--a case report.

    Leprosy is rarely diagnosed in our part of the world. In our 26-year-old patient, borderline lepromatous leprosy was first diagnosed in 1992 and was treated with Rifoldin, Lemprene and Dapson according to the standard WHO scheme of treatment. Ophthalmic examination showed minor epithelial lesions of the cornea in both eyes, a reduced corneal reflex in the left eye and a scleral leproma nasally and close to the limbus, also in the left eye. In 1995, the patient was examined again and was treated as above for lepromata of the left eyebrow nasally and of both lower legs. Ophthalmic examination revealed conjunctival irritation, anterior uveitis with leprosy pearls on the pupillary margin and secondary glaucoma. The glaucoma was treated with hypotonics, the uveitis was treated with topical cortisone. The intra-ocular pressure normalised and the uveitis improved. Of the two main types of leprosy, lepromatous leprosy and tuberculoid leprosy, our patient had the second, milder form.
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5/5. Leprous neuropathy: an American perspective.

    Although its overall prevalence is decreasing, leprosy continues to be a major cause of neuropathy worldwide. In the united states, it is a relatively rare condition. As a result, physicians may lack familiarity with the disease, which can delay diagnosis and treatment. Leprous neuropathy is characterized by involvement of dermal nerves and superficial peripheral nerve trunks in cooler body regions. A continuing pattern of immigration from endemic areas may allow practicing neurologists in any region of the country to become involved in the care of patients with leprosy. The diagnosis should be considered in patients from endemic regions presenting with peripheral neuropathy with or without skin lesions. Readily available diagnostic testing, access to subspecialists, and modern transportation and information systems through the satellite clinics of the Hansen's disease center serve as major advantages for the management of leprosy patients in the united states.
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