瘤型麻风发生Ⅱ型麻风反应

A case of lepromatous leprosy with type Ⅱ leprosy reaction

报告1例瘤型麻风发生Ⅱ型麻风反应。患者女,43岁。因眉毛脱落11余年,全身散在红斑2年余,加重伴发热4 d就诊。皮肤科检查:面部、躯干、四肢有大小不一的斑疹、斑块及结节,双耳垂肥大,眉毛、睫毛脱落,右侧耳大神经粗大。无麻风病家族史,在省外务工11余年期间,被误诊为"脂膜炎"、"荨麻疹"及"银屑病"。皮损组织液涂片查抗酸杆菌阳性,腹部皮损组织病理检查为瘤型麻风。诊断:瘤型麻风发生Ⅱ型麻风反应。

A case of lepromatous leprosy with type Ⅱ leprosy reaction is reported. A 37-year-old female presented with madrosis（loss of eyebrows） for more than 11 years and generalized scattered erythemas for 2 years, accompanied with fever for 4 days with no family history of leprosy. Physical examination showed different-sized red maeules, plaques and nodules on the face, trunk and limbs. Hypertrophy of ear lobes, loss of eyebrows and eyelashes and enlargement of right great auricular nerve were observed. The patient was misdiagnosed as panniculitis, urticaria and psoriasis during past 11 years as a worker in other provinces. Tissue fluid smear was positive for acid fast bacilli. Histopathological examination revealed lepromatous leprosy. The diagnosis of lepromatous leprosy with type Ⅱ leprosy reaction was made.