Erythroderma as a manifestation of leprosy.

Erythroderma consists of erythema and scaling involving most or all of the body surface. This generalized eruption may be idiopathic, drug-induced or secondary to cutaneous or systemic disease. A 71-year-old man is reported presenting generalized erythema and desquamation with deck-chair sign, nail dystrophy, and plantar ulcers associated with loss of local tactile sensitivity. Biopsies from three different sites demonstrated diffuse lymphocytic infiltrate with incipient granulomas. Fite-Faraco staining showed numerous isolated bacilli and globi. The skin smear was positive. Clinical and pathological diagnosis of borderline lepromatous leprosy was confirmed. This report demonstrates that chronic multibacillary leprosy can manifest as erythroderma and thus should be included in the differential diagnosis.

Erythroderma as a manifestation of leprosy

Abstract: Erythroderma consists of erythema and scaling involving most or all of the body surface. This generalized eruption may be idiopathic, drug-induced or secondary to cutaneous or systemic disease. A 71-year-old man is reported presenting generalized erythema and desquamation with deck-chair sign, nail dystrophy, and plantar ulcers associated with loss of local tactile sensitivity. Biopsies from three different sites demonstrated diffuse lymphocytic infiltrate with incipient granulomas. Fite-Faraco staining showed numerous isolated bacilli and globi. The skin smear was positive. Clinical and pathological diagnosis of borderline lepromatous leprosy was confirmed. This report demonstrates that chronic multibacillary leprosy can manifest as erythroderma and thus should be included in the differential diagnosis.

Risk factors for type 1 reactions in leprosy

A cohort of new borderline leprosy patients seen over a 7-year period were examined retrospectively for risk of type 1 reactions (T1R) associated with 12 clinical and laboratory parameters. Logistic regression analysis was used to identify a strong link between facial patches and cutaneous T1R and enlarged ulnar nerves and neural T1R. Anti-phenolic glycolipid-I seropositivity, a positive bacterial index, and disease in more than two body areas were also identified as risk factors for T1R. These data indicate that there are important clinical data which can be used to predict an individual patient's risk of developing T1R.

Hanseníase: contribuiçao aos parâmetros da classificaçao

O autor comprovou que a adoçao dos critérios de Ridley-Jopling, simultaneamente com os parâmetros de classificaçao de Madri, contribuiu no Brasil, a partir de 1970, para o aumento do número de diagnósticos de hanseníase dimorfa atingindo, as vezes, o percentual de 25 por cento. Os parâmetros de Ridley-Jopling permitiram classificarem subgrupos apenas 32 por cento dos dimorfos. Observou que os critérios de classificaçao de Madri nem sempre foram utilizados: a falta de informaçoes sobre o número e limites das lesoes cutaneas chegou a 45 por cento; a baciloscopia nao consta de 20 por cento dos prontuários; o teste de Mitsuda deixou de ser realizado em 48 por cento de uma das amostras; o exame histopatológico, apesar de mais laborioso, somente nao foi feito em 3,6 por cento dos casos