Wednesday, November 9, 2011

Histoid leprosy. Clinical case


Leprosy Mailing List – October 30th, 2011 
Ref.:   Histoid leprosy. Clinical case
From: A G Barminus, Garkida, Adamawa State, Nigeria

Dear Dr Noto,
I wish to thank Dr Salafia (and also Drs Verduga and Barreto) for sharing with us their clinical experience in the field of leprosy.  I think that Dr Salafia’s case No 10 is histoid leprosy.  I would like contributing to this discussion by sending some clinical pictures of histoid leprosy for readers to see and advise (optimal length of treatment?).  They are hereby attached.  The pictures are mine and with the consent of the patient.
The patient is a new case of leprosy.  He never had any form of treatment for leprosy.  There was no nerve tenderness and the disability grade at diagnosis was zero.  No evidence of type 2 reaction.  Bacteriological index (BI) was 5+; the morphological index (MI) was 20 %.  Histology was not done as there is no facility for this in the area.  As for treatment, the patient was placed on normal multi-drug therapy (MDT) and he is still on it.  He is presently on the 6th month of MDT and there is just some improvement in the clinical picture.  How long will it take for these lesions to disappear?  Any experience?
Thank you very much in advance for your comments. 
Dr Augustine Barminus 
Chief Medical Officer
State dermatology hospital
Garkida
Adamawa state
Nigeria

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