RESUMO
Ulcers with maculo-papular rash are an unusual presenting feature of leprosy. They occur as result of neuropathy, type-2 lepra reaction or Lucio's phenomenon. The hall mark of type-2 reaction is erythema nodosum. Very rarely it manifests as ulcerative skin lesions. We describe one such unusual case of a young male who presented with multiple ulcers and maculo-papular rash over the legs, chest and abdomen. In addition to this, he had fever, heart murmur, pulmonary infiltrates, neuropathy, and deranged liver function. A clinical differential diagnosis of infective endocarditis and systemic nectrozing vasculitis was made. Skin biopsy showed dense inflammation with lepra bacilli consistent with type-2 lepra reaction.
Assuntos
Hanseníase Virchowiana/complicações , Hanseníase Virchowiana/patologia , Dermatopatias/microbiologia , Dermatopatias/patologia , Úlcera/microbiologia , Úlcera/patologia , Abdome , Adulto , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Quimioterapia Combinada , Ecocardiografia , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/tratamento farmacológico , Endocardite Bacteriana/microbiologia , Humanos , Perna (Membro) , Hansenostáticos/uso terapêutico , Hanseníase Virchowiana/tratamento farmacológico , Pneumopatias/diagnóstico por imagem , Pneumopatias/microbiologia , Masculino , Tórax , Tomografia Computadorizada por Raios XRESUMO
Seventy-six patients of multibacillary leprosy received clofazimine as part of multidrug therapy (MDT) for periods ranging between 6 and 24 months. Complete ocular examination including slit lamp microscopy and examination of tears was carried out in all these patients. Reddish brown conjunctival and corneal pigmentation was seen in 46% and 53% of the patients respectively. Clofazimine crystals in tears were found in 32% of the patients. Apart from this no other eye changes or symptoms attributable to clofazimine were observed.