Subject(s)
Leprosy, Lepromatous/diagnosis , Adult , Clofazimine/administration & dosage , Clofazimine/therapeutic use , Dapsone/administration & dosage , Dapsone/therapeutic use , Drug Therapy, Combination , Granuloma/pathology , Guinea/ethnology , Histiocytes/pathology , Humans , Leprostatic Agents/therapeutic use , Leprosy, Lepromatous/drug therapy , Leprosy, Lepromatous/pathology , Male , Morocco , Rifampin/administration & dosage , Rifampin/therapeutic use , Staining and LabelingABSTRACT
BACKGROUND: With 254,525 new cases reported in 2007, leprosy is the worlds' second most widespread form of mycobacteriosis. According to the WHO, eradication of leprosy as a public health problem (defined by less than one case per 10,000 people) has been globally achieved. High endemic zones, however, still subsist. Leprosy rates among children, which reflect a country's endemic level, ranged from 0.55 to 19.2 % in 2006. Due to world population migrations, cases of leprosy are now seen in mainland France, in both children and adults. PATIENTS AND METHODS: We describe three leprosy patients aged under 15 years treated at the Dermatology Unit of Saint Louis Hospital between 1st January 2002 and 31st December 2008. The three cases described account for 3 % of new patients treated for leprosy at Saint Louis Hospital over this 7-year period. All were born in an endemic country. Lesions appeared 18 months after arrival in France in two cases and clinical diagnosis was made in only one case. Due to absence of sensory loss in the lesions, diagnosis was reliant upon histopathological examination in two cases. CONCLUSION: Leprosy should be suspected in children from endemic countries presenting skin lesions, particularly hypochromic lesions, even if there is no sensory loss, regardless of how long they have been living in France.
Subject(s)
Leprosy/diagnosis , Adolescent , Adrenal Cortex Hormones/therapeutic use , Age of Onset , Biopsy , Brazil/ethnology , Child , Drug Therapy, Combination , Endemic Diseases , Female , France/epidemiology , Guinea/ethnology , Humans , India/ethnology , Leprosy/drug therapy , Leprosy/epidemiology , Leprosy/pathology , Male , Retrospective Studies , Rifampin/therapeutic use , Skin/pathologyABSTRACT
CASE REPORT: A case of bilateral facial palsy with paralytic ectropion, lagophthalmos and corneal damage secondary to corneal exposure in a long-standing patient with lepromatous leprosy is presented. Correction of paralytic ectropion was performed by medial cantoplasty, tarsal strip and Medpor lower eyelid spacer implantation. Lagophthalmos was corrected by gold weight implant in the upper tarsus. DISCUSSION: Ocular findings in leprosy appear in 72% of patients. Facial nerve palsy occurs in 3-19.8%, being bilateral in 5%. In long standing cases with corneal complications secondary to exposure, surgical treatment is required.
Subject(s)
Eyelid Diseases/etiology , Facial Paralysis/etiology , Leprosy, Lepromatous/complications , Aged , Ectropion/etiology , Ectropion/surgery , Eyelid Diseases/surgery , Facial Nerve/physiopathology , Female , Gold , Guinea/ethnology , Humans , Polyethylene , Prostheses and ImplantsABSTRACT
CASE REPORT: A case of bilateral facial palsy with paralytic ectropion, lagophthalmos and corneal damage secondary to corneal exposure in a long-standing patient with lepromatous leprosy is presented. Correction of paralytic ectropion was performed by medial cantoplasty, tarsal strip and Medpor lower eyelid spacer implantation. Lagophthalmos was corrected by gold weight implant in the upper tarsus. DISCUSSION: Ocular findings in leprosy appear in 72 per cent of patients. Facial nerve palsy occurs in 3-19.8 per cent, being bilateral in 5 per cent. In long standing cases with corneal complications secondary to exposure, surgical treatment is required.