界线类偏瘤型麻风伴Ⅱ型麻风反应1例

A Case of Borderline Lepromatous Leprosy with Type Ⅱ Leprosy Reaction

患者男,16岁。双小腿红斑1年,加重伴结节3月。当地医院以"硬红斑"予"利福平等抗结核"治疗后出现红斑、结节增多,伴发热、肌痛。专科情况:右侧肢体痛觉、温度觉、触觉减退。躯干散在淡红斑片,四肢散在暗红斑,于双下肢融合成片,并触及数个绿豆至蚕豆大小结节,伴压痛。皮损病理:真皮及皮下组织内肉芽肿形成,皮下组织内隔性脂膜炎改变;抗酸染色查见大量阳性杆菌。诊断:界线类偏瘤型麻风伴Ⅱ型麻风反应。

A-16-year-oht boy presented with erythema on shins for one year,the situation aggravated along with nodules for 3 months. He was misdiagnosed as Erythema induratum,and suffered from new erythematous nodules with fever and myalgia after antituberculosis therapy. The skin lesions manifested as sporadic erythema,patches on the trunk and limbs, and nodules on both legs with tenderness. Clinical examination revealed decrease sensation to temperature his right limbs. Both biopsies of the skin tissue from the waist and leg demonstrated granulomatous nodulars in the dermis and subcutaneous, and septal panniculitis in subeuianeous. Fire stain revealed numerous bacilli,confirming the diagnosis of borderline lepromatous leprosy with type 11 leprosy reaction.