PMID: 9527755Jan 1, 1997Paper

Atypical presentations of leprosy: apropos of 2 cases

Acta Leprologica
L Benzekri, B Hassam

Abstract

This report describes two atypical cases of leprosy. A 48 year old male patient presented laryngeal dyspnea with adhesions of the oropharynx of which the biopsies were inconclusive. The patient was cachectic with hyperesthesia of the extremities and two subcutaneous nodules. The biopsy of one nodule evoked thesaurismosis or dyslipoidosis while the bacilloscopy was positive in nasal smears. A 14 year old female patient suffered from bullae which appeared spontaneously on erythematous skin on the legs and upper arms. Upon examination those areas were found to be hypoaesthetic, as was a very large hamartoma on the left half of the body. A biopsy of healthy skin evoked the diagnosis of leprosy. The patient then developed BT leprosy and episodes of hysteria. The first observation led to several diagnoses: while laryngeal dyspnea is unusual in LL and while cutaneous histology of regressive LL contrasted with the abundance of the bacilloscopy. The diagnosis of the second case is that of indeterminate leprosy with premonitory neurological signs associated with pathomania and evolution to a multibacillary form.

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