DermAtlas: Online Dermatology Image Library dermatology image,leprosy,leprosy, histoid,leprosy, histoid,leprosy, histoid,leprosy, histoid,leprosy, histoid,leprosy, lepromatous,mycobacterium infection,leprosy, borderline-tuberculoid

© 2001-2010, DermAtlas	*Image Name:*	leprosy_1_091201	*File Type:*	jpg
	*Diagnosis:*	LEPROSY / LEPROSY, HISTOID	*Category:*	infections and infestations
	*Body Site:*	ear lobe / arm hand / leg trunk	*Age:*	40 years
	*Contributors:*	Eric Weisberg Greg Hosler, MD, PhD
	*Description:*	Hypopigmented plaques with scattered papules are present on the dorsal hands. Similar findings are on the trunk and extremities (not shown).
	*Comments:*	This young man presented with slowly progressive patches and plaques over his face, trunk and extremities. These were associated with dysesthesia. Clinical considerations included infections as well as sarcoidosis. Biopsy confirmed the diagnosis of leprosy. This is a rare case of histoid leprosy, where nodules develop on otherwise normal skin. The histology supports this with a nodule of histiocytes and numerous organisms. The significance of histoid leprosy is unclear. This patient traveled to India several decades ago, but denies any interval exposure. This interval is at the upper limits reported for leprosy.
	*Related Images:*	All related Images leprosy_5_091201 leprosy_4_091201 leprosy_3_091201 leprosy_2_091201 leprosy_6_091201

© 2001-2010, DermAtlas	*Image Name:*	leprosy_2_091201	*File Type:*	jpg
	*Diagnosis:*	LEPROSY / LEPROSY, HISTOID	*Category:*	infections and infestations
	*Body Site:*	ear lobe / arm hand / leg trunk	*Age:*	40 years
	*Contributors:*	Eric Weisberg Greg Hosler, MD, PhD
	*Description:*	Warty plaques and nodules are present on the ear lobes bilaterally. These are mildly indurated.
	*Comments:*	This young man presented with slowly progressive patches and plaques over his face, trunk and extremities. These were associated with dysesthesia. Clinical considerations included infections as well as sarcoidosis. Biopsy confirmed the diagnosis of leprosy. This is a rare case of histoid leprosy, where nodules develop on otherwise normal skin. The histology supports this with a nodule of histiocytes and numerous organisms. The significance of histoid leprosy is unclear. This patient traveled to India several decades ago, but denies any interval exposure. This interval is at the upper limits reported for leprosy.
	*Related Images:*	All related Images leprosy_5_091201 leprosy_4_091201 leprosy_3_091201 leprosy_1_091201 leprosy_6_091201

© 2001-2010, DermAtlas	*Image Name:*	leprosy_3_091201	*File Type:*	jpg
	*Diagnosis:*	LEPROSY / LEPROSY, HISTOID	*Category:*	infections and infestations
	*Body Site:*	ear lobe / arm hand / leg trunk	*Age:*	40 years
	*Contributors:*	Eric Weisberg Greg Hosler, MD, PhD
	*Description:*	There is a diffuse infiltrate within the dermis. It is vaguely wedge shaped. The epidermis is uninvolved.
	*Comments:*	This young man presented with slowly progressive patches and plaques over his face, trunk and extremities. These were associated with dysesthesia. Clinical considerations included infections as well as sarcoidosis. Biopsy confirmed the diagnosis of leprosy. This is a rare case of histoid leprosy, where nodules develop on otherwise normal skin. The histology supports this with a nodule of histiocytes and numerous organisms. The significance of histoid leprosy is unclear. This patient traveled to India several decades ago, but denies any interval exposure. This interval is at the upper limits reported for leprosy.
	*Related Images:*	All related Images leprosy_5_091201 leprosy_4_091201 leprosy_2_091201 leprosy_1_091201 leprosy_6_091201

© 2001-2010, DermAtlas	*Image Name:*	leprosy_4_091201	*File Type:*	jpg
	*Diagnosis:*	LEPROSY / LEPROSY, HISTOID	*Category:*	infections and infestations
	*Body Site:*	ear lobe / arm hand / leg trunk	*Age:*	40 years
	*Contributors:*	Eric Weisberg Greg Hosler, MD, PhD
	*Description:*	There are zones with a necrotic appearance, consisting of sheets of histiocytes with a granular quaity to the cytoplasm. A mixed infiltrate cuffs these histiocytic zones.
	*Comments:*	This young man presented with slowly progressive patches and plaques over his face, trunk and extremities. These were associated with dysesthesia. Clinical considerations included infections as well as sarcoidosis. Biopsy confirmed the diagnosis of leprosy. This is a rare case of histoid leprosy, where nodules develop on otherwise normal skin. The histology supports this with a nodule of histiocytes and numerous organisms. The significance of histoid leprosy is unclear. This patient traveled to India several decades ago, but denies any interval exposure. This interval is at the upper limits reported for leprosy.
	*Related Images:*	All related Images leprosy_5_091201 leprosy_3_091201 leprosy_2_091201 leprosy_1_091201 leprosy_6_091201

© 2001-2010, DermAtlas	*Image Name:*	leprosy_5_091201	*File Type:*	jpg
	*Diagnosis:*	LEPROSY / LEPROSY, HISTOID	*Category:*	infections and infestations
	*Body Site:*	ear lobe / arm hand / leg trunk	*Age:*	40 years
	*Contributors:*	Eric Weisberg Greg Hosler, MD, PhD
	*Description:*	Deeper in the dermis, there is a longitudinal section of a peripheral nerve. The histiocytic infiltrate encases the nerve.
	*Comments:*	This young man presented with slowly progressive patches and plaques over his face, trunk and extremities. These were associated with dysesthesia. Clinical considerations included infections as well as sarcoidosis. Biopsy confirmed the diagnosis of leprosy. This is a rare case of histoid leprosy, where nodules develop on otherwise normal skin. The histology supports this with a nodule of histiocytes and numerous organisms. The significance of histoid leprosy is unclear. This patient traveled to India several decades ago, but denies any interval exposure. This interval is at the upper limits reported for leprosy.
	*Related Images:*	All related Images leprosy_4_091201 leprosy_3_091201 leprosy_2_091201 leprosy_1_091201 leprosy_6_091201

© 2001-2010, DermAtlas	*Image Name:*	leprosy_1_091120	*File Type:*	jpg
	*Diagnosis:*	LEPROSY / LEPROSY, LEPROMATOUS / MYCOBACTERIUM INFECTION	*Category:*	infections and infestations / lumps & bumps (plaques, nodules, tumors)
	*Body Site:*	face / forehead cheek / chin	*Age:*	17 years
	*Contributor:*	Lahiri Koushik
	*Description:*	discrete and confluent annular violaceous edematous plaqaues with hyperpigmented borders and overlying scale and crusts
	*Comments:*	This adolescent girl with hypopigmented patches on her face, extremities, and trunk for months developed erythema and edema of the skin lesions in association with fever and arthralgias. Her skin findings, immunologic status, and skin biopsy were consistent with borderline lepromatous leprosy.

© 2001-2010, DermAtlas	*Image Name:*	BT_Hansens_TypeI_Reaction_1_090828	*File Type:*	jpg
	*Diagnosis:*	LEPROSY / LEPROSY, BORDERLINE-TUBERCULOID	*Category:*	infections and infestations / hypersensitivity
	*Body Site:*	hand	*Age:*	17 years
	*Contributor:*	Lanka Padmavathy, PhD
	*Description:*	17 year old boy with multiple anestheic patches over body. Started on treatment with anti-leprosy drugs.Developed erythema and swelling of existing patches over the dorsum of hand and fingers
	*Comments:*	This adolescent boy was diagnosed with borderline-tuberculoid leprosy when he was evaluated for multiple disseminated anesthetic patches. When he was treated with anti-leprosy drugs he developed swelling and erythema of the existing patches on the top of the hand and fingers. This type 1 reaction was subsequently treated with oral prednisone.

© 2001-2010, DermAtlas	*Image Name:*	Nerve_abscess_1_090304	*File Type:*	jpg
	*Diagnosis:*	LEPROSY	*Category:*	abscess / infections and infestations / linear eruptions
	*Body Site:*	forearm / hand / wrist	*Age:*	19 years
	*Contributor:*	Piyush Kumar
	*Description:*	linear array of papules and nodules one of which was ulcerated
	*Comments:*	This 19-year-old man was evaluated for swelling over the left forearm in a linear distribution for 2 months associated with an ulcer on the wrist for 1 month. The nonhealing ulcer was preceded by a soft nodule. The left ulnar nerve was thickened and tender, and there was loss of sensation in area supplied by the nerve. Atrophy of the instrinsic muscles of the left hand and deformity middle finger were noted. No other nerves were involved. The diagnosis of pure neuritic leprosy with nerve abscess was confirmed by identifying organisms on stains of debris obtained from the ulcer.

© 2001-2010, DermAtlas	*Image Name:*	Leprosy_1_071207	*File Type:*	jpg
	*Diagnosis:*	LEPROSY	*Category:*	infections and infestations
	*Body Site:*	face / eye	*Age:*	19 years
	*Contributor:*	Soe Win Oo, MD
	*Description:*	well demarcated violaceous indurated plaques
	*Comments:*	A 19-year-old girl was evaluated for violaceous plaques her face for 4 months. She had decresed sensation and weakness when opening and closing and the left eye. Slit skin smears were positive for organisms, and she was diagnosed with borderline leprosy.

© 2001-2010, DermAtlas	*Image Name:*	leprosy_3_060801	*File Type:*	jpg
	*Diagnosis:*	LEPROSY	*Category:*	infections and infestations / granulomatous disorder
	*Body Site:*	knee	*Age:*	20 years
	*Contributor:*	Greg Hosler, MD, PhD
	*Description:*	A modified acid fast stain (FITE) highlights numerous clumps of red bacilli within the granulomatous infiltrate.
	*Comments:*	This 20 year-old female grew up in the Marshall Islands. She presented with a red, scaly plaque on her knee. She also reported decreased sensation. The clinican's differential diagnosis was leprosy, psoriasis, or erythema annulare centrifugum. While not so rare in other parts of the world, a good case of leprosy continues to spark excitement here. I should have the pleasure to see more examples as the 9-banded armadillo roams this region (Texas). This is an example of Hansen disease. The presence of numerous acid-fast-positive organisms favors a diagnosis of lepromatous leprosy. This case is probably best classified as borderline lepromatous since the granulomas are a little better formed and there is a sense of neurotropism, features seen in the tuberculous form...cool case.
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