Bullous tuberculoid leprosy: report of a case, with a discussion of Lazarine leprosy

RESUMO

Our records of the case here reported cover the period from 1930 to the present time, during which period the course of the disease has shown startling developments. In one phase there suddenly appeared numerous bullae, followed by ulceration and finally leading to the formation of a mixture of pigmented, achromic and spotted scars. These phenomena, taken together, used to be regarded by some of the old writers as characteristic of the so-called "lazarine leprosy". The original rapidly spreading macular lesions in our case showed a typical tuberculoid picture both clinically and histologically, with numerous bacilli. The occurrence of bullae in the course of the different types of the disease is discussed. Perhaps because it is commonly known that blisters do sometimes occur in the "pure" neural and the lepromatous types, as well as in acute tuberculoid reaction, "lepra lazarina" is not at present looked upon as a separate type or subtype of the disease and is seldom mentioned. However, the article of Pardo-Castella and Caballero (1931), which described a peculiar monosymptomatic form of the sisease, accompanied by blister formation, which those authors called lazarine leprosy, has awakened anew considerable interest in this old term. Pending restudy of the histology of their cases in the light of current knowledge of tuberculoid leprosy, it is suggested the term lazarine leprosy be limited to this special Cuban form. We have tentatively designated our case as one of bullous tuberculoid leprosy.