Lepromatous leprosy and the differential diagnosis with other systemic diseases

Leprosy is a disease caused by Mycobacterium leprae, with skin manifestations accompanied by loss of sensation and involvement of the peripheral nervous system that can also affect mucous membranes and viscera. Brazil ranks 2nd in the ranking of disease prevalence. The classification of leprosy itse...

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Detalles Bibliográficos
Autores: Ito, Lúcia Mioko, Oliveira, Amanda VC, Miranda, GiulianaAngelucci, Tamanini, Juliana Milhomem, Mello, Cristina Van Blarcum de Graff, Santos, Elberth José dos, Machado Filho, Carlos D´Aparecida Santos
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2014
País:Brasil
Institución:Instituto Lauro de Souza Lima (ILSL)
Repositorio:Hansenologia Internationalis (Online)
Idioma:portugués
OAI Identifier:oai:ojs.periodicos.saude.sp.gov.br:article/35032
Acceso en línea:https://periodicos.saude.sp.gov.br/hansenologia/article/view/35032
Access Level:acceso abierto
Palabra clave:Hanseníase
Linfoma
Hanseníase Virchowiana
Mycobacterium leprae
Linfoma Cutâneo de Células T
Linfoma não Hodgkin
Lymphoma
Lymphoma, Non-Hodgkin
Lymphoma, T-Cell, Cutaneous
Leprosy
Leprosy, Lepromatous
Descripción
Sumario:Leprosy is a disease caused by Mycobacterium leprae, with skin manifestations accompanied by loss of sensation and involvement of the peripheral nervous system that can also affect mucous membranes and viscera. Brazil ranks 2nd in the ranking of disease prevalence. The classification of leprosy itself shows its clinical polymorphism; and allows intersections with diseases such as non-Hodgkin lymphoma. This is a malignant neoplasm of lymph nodes, and may manifest primarily in the skin. A 51 years-old male patient came to us complaining of “chapped skin”, lesions in the mouth and the tongue and weight loss. On physical examination there was the presence of plaques on the palate, whitish formations on back of tongue and ear lobe infiltration. We identified sensory changes, widespread erythematous rash, a tumor in the elbow, and infiltrated erythematous lesions with exulcerations in lower limbs. The diagnostic hypotheses were: mucocutaneous leishmaniosis, AIDS, secondary syphilis, leprosy and non-Hodgkin lymphoma. During the investigation, all serological test were negative, however, acid fast bacilli staining and biopsy suggested lepromatous leprosy. After multidrugtherapy treatment there was complete resolution of the lesions. In lepromatous leprosy solid nodular, papular lesions or plaques with variable characteristics may be noticed. Additionally, thickening of the pinna, madarosis and nasal obstruction can be found. Lesions in the oral cavity are also described in cases of lepromatous leprosy. Non-Hodgkin lymphomas with primary cutaneous presentation, may resemble indeterminate forms of leprosy, since they are characterized as lymphoreticular neoplasms that arise during the natural history of the disease, in extranodal tissues, including the skin.