Cases reported "Leprosy, Tuberculoid"

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11/25. Relapse in leprosy after multidrug therapy and its differential diagnosis with reversal reaction.

    Relapse may be caused either by persisters or through reinfection in a patient released from treatment after MDT. Differentiating relapse from reversal reaction is not always easy, on histological and clinical grounds. A therapeutic trial with steroids for 2-4 weeks can be used to differentiate relapse from reversal reaction occurring in the skins. However, if a patient develops nerve function deficit after release from treatment, it is best to initiate antileprosy treatment along with a long course of steroids.
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ranking = 1
keywords = nerve
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12/25. Giant nerve abscesses in leprosy.

    Two leprosy patients with neuritis caused by giant abscesses involving almost the entire ulnar nerve are described. One patient, who also had skin lesions, was diagnosed histopathologically as having borderline tuberculoid leprosy both on skin and nerve biopsy, and the other, with only nerve involvement, belonged to the pure neuritic group. The lepromin test was strongly positive (with a vesicular reaction in one patient) and lymphocyte transformation to mycobacterium leprae antigen was raised. These lesions can be easily mistaken for a peripheral nerve tumour in places where leprosy is uncommon. A brief account of the management of nerve abscess in leprosy is given.
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ranking = 9
keywords = nerve
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13/25. Leprotic involvement of peripheral nerves in the absence of skin lesions. Case report and literature review.

    In the absence of clinically apparent cutaneous lesions, primarily neural leprosy is uncommon. Primarily neural leprosy presents clinically as a peripheral neuropathy that most frequently affects motor nerves and that occasionally involves sensory nerves as well. The long incubation period for leprosy and its occurrence outside endemic areas often lead to delayed diagnosis. We present a case of glove and stocking hypoesthesia, weakness of the flexor muscle of the right great toe, palpable thickening of the right popliteal nerve, and hypoesthetic but normal-appearing areas on the back, which developed in a Trinidadian immigrant who lived in canada for 16 years. A skin biopsy specimen obtained from a visibly normal but hypoesthetic area on the back demonstrated a few acid-fast bacteria in small dermal nerves, in arrector pili smooth muscle, and in rare perivascular histiocytes, associated with a sparse mixed inflammatory cell infiltrate. The patient responded well to therapy with dapsone, rifampin, and clofazamine. A classification and review of primarily neural leprosy is presented. Our patient represents the first reported case of primarily neural borderline lepromatous leprosy in canada.
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ranking = 8
keywords = nerve
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14/25. A case of isolated tuberculoid leprosy of brachial cutaneous nerve.

    The author relates a rare case of cutaneous-brachial nerve mononeuritis in a Hansen's disease patient, presenting a pure neural tuberculoid form, with spontaneous drainage of abscess.
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ranking = 5
keywords = nerve
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15/25. Multiple cutaneous nerve abscesses on a healed tuberculoid patch.

    A case of healed tuberculoid leprosy (TT) with multiple superficial nerve abscesses involving the whole cutaneous network on the patch is reported. To the best of our knowledge multiple cutaneous nerve abscesses involving the entire subcutaneous plexus on a TT patch is a very uncommon observation.
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ranking = 6
keywords = nerve
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16/25. Calcification of ulnar nerve in a patient with tuberculoid leprosy--a case report.

    A case of Tuberculoid leprosy who showed Evidence of Calcification of Right ulnar nerve at elbow on Radiological Examination is reported.
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ranking = 4
keywords = nerve
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17/25. Calcification of ulnar nerve in leprosy--a case report.

    A case of Tuberculoid leprosy who had taken irregular treatment for five years and had thickened ulnar nerve which on radiological examination showed calcification, is reported.
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ranking = 5
keywords = nerve
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18/25. The pathology of early leprous neuropathy.

    A qualitative and quantitative study was made of early changes in nerves from 10 patients with tuberculoid or lepromatous type of leprosy. Five nerve biopsies, taken from sites remote from skin lesions, were considered to be unaffected when examined by paraffin histology but showed abnormalities in semi-thin resin sections and by electron microscopy; 5 showed mild to moderate involvement by paraffin histology. Changes in 'unaffected' nerves in both types of leprosy included the presence of subperineurial oedema; occasional evidence of fibre regeneration, sometimes with atypical features; increased numbers of small myelinated fibres, possibly a consequence of axonal atrophy; a few thinly remyelinated fibres, probably due to secondary demyelination, and some loss of unmyelinated axons. In more affected nerves there was variable loss of axons, both myelinated and unmyelinated. Demyelination was not a conspicuous feature; there was evidence of axonal atrophy in some fibres. Similarities in some of the changes observed in tuberculoid and lepromatous types of leprosy suggest a common mechanism of nerve damage, at least in the early stages. The presence of abnormalities in nerves at a distance from skin lesions implies a more diffuse nerve involvement than might have been expected in both types of leprosy.
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ranking = 7
keywords = nerve
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19/25. Multiple cranial neuropathies associated with leprosy.

    We report on a Samoan man with dysphagia, voice hoarseness, facial erythema, and edema. neurologic examination revealed hypesthesia at the site of the facial rash, enlarged auricular nerves, a right facial palsy, decreased gag reflexes, and voice hoarseness. Laryngoscopic examination showed paralysis of the left vocal cord, and a barium swallow revealed a possible compressive lesion. A skin biopsy specimen was diagnostic of tuberculoid leprosy. This patient has an unusual case of leprosy with multiple cranial neuropathies.
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ranking = 1
keywords = nerve
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20/25. Cytological needle aspiration of the nerve for the diagnosis of pure neural leprosy.

    Pure neural (also called primary neuritic) leprosy manifests itself by involvement of only the nerve in the absence of skin lesions. Therefore, it sometimes can pose a diagnostic problem. Cytological needle aspiration of an affected nerve can be a valuable tool under such circumstances. The method as developed at Anandaban leprosy Hospital, nepal, is described and two cases are presented.
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ranking = 6
keywords = nerve
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