RESUMEN
RosaiDorfman disease (RDD) is a rare, self-limiting disease of uncertain etiology involving lymph nodes as well as extranodal sites. Isolated or pure cutaneous RDD (PCRDD) without lymph node involvement is very unusual accounting for only 3% of all described cases of RDD. The clinical features of PCRDD are quite different from RDD according to the literature on extranodal RDD, thereby emphasizing that PCRDD is a distinct clinical entity. Histopathology remains the gold standard for the diagnosis of both systemic and PCRDD with the presence of characteristic emperipolesis observed in histiocytes while immunohistochemistry (IHC) (S100, CD 68 positive, and CD 1a-negative) serves as a useful adjunct. We hereby report a case of a 36-year-old female who presented with a tender, indurated plaque on the left forearm with a clinical differential diagnosis of borderline tuberculoid leprosy/sarcoidosis and lupus vulgaris. However, on histopathology, a diagnosis of RDD was performed and confirmed on IHC. This case highlights the need to create awareness among young pathologists and clinicians about PCRDD to prevent overzealous treatment.
RESUMEN
BACKGROUND: In India, leprosy still continues to be one of the major public health problems and demands a continuous awareness for its eradication. The reduction of the load of infection is the cornerstone of leprosy control. AIMS: The aim of the present study was to enumerate the epidemiology of leprosy in the Ahmedabad district of Gujarat. METHODS: Three hundred new cases of leprosy (multidrug therapy cases) and patients who had completed antileprosy treatment and developed new signs and symptoms after that during the period from June 2010 to December 2012 were included in the study. A detailed history, clinical examination, and relevant tests were done. RESULTS: Out of a total of 300 patients, male-to-female ratio was 2.1:1. Family history was positive in 4.3% of patients. Lepromatous leprosy was seen in 27.3%, pure neuritic leprosy occurred in 12 (3.9%), and smear positivity was seen in (44.6%). Thirty (10%) patients developed type 1 reaction and 32 (10.6%) patients had type 2 reaction. Nearly 1.3% of the cases were relapsing cases. LIMITATIONS: The study had geographical limitation and the study did not cater the whole population but only the cases who reported to the hospital. Hence, the social stigma factor associated with leprosy could not be annulled. CONCLUSIONS: Leprosy still prevails and adequate knowledge and clinical skills, sensitive diagnostic tools and proper supply of medicines from the medical end and early reporting of symptoms, compliance regarding medicine intake, and social awareness to null social stigma associated with it from the patient's end may bring the country as a whole to the target of leprosy elimination.