Leproma Presenting as a Nasal Cavity Mass.

Leprosy is a rare disease and unfamiliar to many people. A 55-year-old woman was presented to our hospital complaining of nasal obstruction and anosmia. Nasal endoscopic examination revealed reddish-colored exophytic, nonulcerative masses in both nasal cavities. The authors performed endoscopic sinus surgery which involved endoscopic mass removal and synechiolysis. A biopsy sample stained with acid-fast stain and a rapid silver stain showed numerous filamentous organisms infiltrating macrophages, consistent with lepromatous leprosy. The patient was treated with a triple drug regimen of rifampin and dapsone with clofazimine. Herein, the authors present a case of nasal leproma as a differential diagnosis of a nasal cavity mass.

Some more about unfavourable results after corrective surgery as seen in leprosy.

The paper describes unfavourable outcomes of some of the commonly performed surgical procedures in leprosy affected persons and the underlying causes. An awareness about unfavourable outcomes of surgery is helpful to the beginners because they can anticipate the problems and take appropriate measures to prevent that and failing which prepare themselves to face and sort that out. Careful pre-operative evaluation of the patient is an important first step.

Análise dos motivos para o abandono do tratamento: o caso dos pacientes hansenianos da Unidade de Saúde em Carapina/ES / Analysis of reasons for treatment droup put: the case of hansen's disease patient of the Health Unit at Carapina/ES

O abandono do tratamento entre pacientes hansenianos tem constituído um grave problema aos profissionais da área de saúde pública. Este trabalho tem por objetivo analisar os motivos alegados pelos pacientes para a falta e/ou abandono de seus tratamentos. Trata-se de um estudo retrospectivo, envolvendo uma amostra de 42 pacientes que faltaram e/ou abandonaram o tratamento no período de 1994 a 1996. Para coleta de dados utilizou-se roteiro semi-estruturado de entrevista. As respostas foram agrupadas em categorias gerais referentes a fatores intrínsecos e extrínsecos que caracterizaram o abandono e/ou falta. A relaçäo entre falta e abandono entre os pacientes multibacilares (MB) foi 0,8:1 e entre os paucibacilares (PB) 0,7:1. Entre os pacientes do tipo PB destacaram-se os fatores intrínsecos para justificar o abnadono do tratamento e, entre os pacientes MB, evidenciou-se uma prevalência de fatores extrínsecos como justificaçäo de suas faltas. Levando-se em consideraçäo os dados apresentados, há necessidade de maior aprofundamento nessa área, a fim de orientar a proposta metodológica do trabalho no Programa de Controle da Hanseníase

[Lagophthalmos and posterior synechiae of the iris during treatment of leprosy with diaminodiphenylsulfone]. / Lagophthalmus und hintere Synechien der Iris bei der Behandlung der Lepra mit Diamino-diphenyl-sulfon.

Four years after controlled and standardized chemotherapy with diaminodiphenylsulfone (DDS), 316 patients in the leprosarium at Khokana, Nepal were re-examined for ophthalmological findings. Patients who, 4 years earlier, had not had lagophthalmos in either eye, nor posterior synechiae of the iris, had only developed these complications in the meantime if they were suffering from DDS-resistant leprosy. New posterior synechiae of the iris were only found in patients with inactive leprosy who had already had a posterior synechia in the fellow eye four years previously. In cases of inactive leprosy there was also a tendency for existing posterior synechiae to increase. It is emphasized that the development of lagophthalmos or posterior synechiae of the iris indicates that a previously inactive leprosy may have become reactivated in spite of treatment with DDS.