RESUMEN
Reactions in leprosy represent sudden shift in the immunological response and are seen in 11-25% of affected patients. It can be seen before, during or after the completion of multidrug therapy (MDT).1 Two types of reactions are recognized; Type 1 reaction (T1R), seen in borderline leprosy, affecting mainly skin and nerves; type 2 reaction (T2R) or erythema nodosum leprosum (ENL), seen in lepromatous leprosy, characterized by systemic features in addition to cutaneous lesions. Trophic ulcers and ulcerating ENL are well known entities while cutaneous ulceration in T1R is extremely rare; we describe an immune-competent woman with cutaneous ulceration as a presenting feature to highlight the need to recognize this entity at the earliest opportunity.
Asunto(s)
Eritema Nudoso , Lepra Dimorfa , Lepra Lepromatosa , Úlcera Cutánea , Quimioterapia Combinada , Eritema Nudoso/diagnóstico , Eritema Nudoso/tratamiento farmacológico , Eritema Nudoso/etiología , Femenino , Humanos , Leprostáticos/uso terapéutico , Lepra Dimorfa/complicaciones , Lepra Dimorfa/tratamiento farmacológico , Lepra Dimorfa/patología , Lepra Lepromatosa/complicaciones , Lepra Lepromatosa/diagnóstico , Lepra Lepromatosa/tratamiento farmacológico , Úlcera Cutánea/diagnóstico , Úlcera Cutánea/tratamiento farmacológico , Úlcera Cutánea/etiologíaAsunto(s)
Antifúngicos/administración & dosificación , Entomophthorales/aislamiento & purificación , Tuberculosis Cutánea/patología , Cigomicosis/tratamiento farmacológico , Cigomicosis/patología , Adulto , Biopsia con Aguja , Diagnóstico Diferencial , Humanos , Inmunohistoquímica , Masculino , Medición de Riesgo , Muslo , Resultado del Tratamiento , Tuberculosis Cutánea/diagnóstico , Cigomicosis/diagnósticoRESUMEN
Granuloma multiforme (GM) is a chronic granulomatous skin condition which is clinically characterised by annular lesions mainly over sun-exposed areas and histologically by focal necrobiosis and histiocytic granulomas. Its significance lies in the fact that it can clinically resemble tuberculoid leprosy and hence it can be missed. Here, we report a case of GM from India in a 55-year-old female agriculturist, with multiple asymptomatic large annular rings of papules over the photo-distributed areas. Histopathology helps in confirming the diagnosis and in differentiating it from similar clinical and histologic mimics such as granuloma annulare, tuberculoid leprosy, interstitial granulomatous dermatitis or annular sarcoid. Though a high degree of suspicion is needed to diagnose GM, it should be considered as a differential for various annular conditions.
Asunto(s)
Granuloma/diagnóstico , Enfermedades de la Piel/diagnóstico , Dermatitis/diagnóstico , Diagnóstico Diferencial , Femenino , Granuloma/patología , Granuloma Anular/diagnóstico , Humanos , India , Lepra/diagnóstico , Persona de Mediana Edad , Enfermedades de la Piel/patologíaAsunto(s)
Queratosis/complicaciones , Queratosis/diagnóstico , Penfigoide Ampolloso/complicaciones , Penfigoide Ampolloso/diagnóstico , Administración Oral , Adulto , Femenino , Humanos , Queratosis/tratamiento farmacológico , Penfigoide Ampolloso/tratamiento farmacológico , Esteroides/administración & dosificaciónRESUMEN
Epithelioid sarcoma is an uncommon slow-growing soft tissue malignancy, associated with a high incidence of local recurrence and metastasis. We report a 26-year-old male with epithelioid sarcoma on the right palm with a long history of over seven years, which was initially misdiagnosed as cutaneous tuberculosis and epithelioid hemangioendothelioma, as a result of which the treatment was delayed. No metastasis was found in our patient. The patient was referred to the oncology centre where he underwent wide excision of the lesion followed by radiotherapy. The review of the literature including clinical and histological differential diagnosis is presented as it mimics inflammatory, benign tumors as well as other malignant conditions.