瘤型麻风MDT治疗后复发伴Sweet综合征样Ⅱ型麻风反应1例

Relapse as TypeⅡLeprosy Reaction Resembling Sweet′s Syndrome after Receiving MDT Treatment

患者女,29岁,发热10 d,全身丘疹、结节伴疼痛2 d,外院诊断为Sweet综合征,反复治疗无效后就诊于本院。10年前于当地医院诊断为“瘤型麻风”,规律行联合化疗(multidrug therapy,MDT)1年,自述已痊愈。完善皮肤组织病理检查示:表皮增生,真皮血管周围及皮下脂肪层见密集泡沫样细胞浸润,抗酸染色阳性。诊断:瘤型麻风伴Sweet综合征样麻风Ⅱ型反应。患者予甲泼尼龙琥珀酸钠联合沙利度胺抗炎治疗后丘疹及结节明显消退。

A 29-year-old female patient presented with a 10-day history of fever and multiple painful papules and nodules for two days.She had been diagnosed with Sweet′s syndrome in another hospital,but the prescribed therapy remained ineffective.The patient was diagnosed with lepromatous leprosy ten years ago,and claimed recovery after a year of regular multidrug therapy(MDT).Histopathological examination revealed epidermal hyperplasia,a large number of foam-like cells could be seen around the dermal blood vessels and in the subcutaneous fat layer.Acid-fast staining was positive.Diagnosis:lepromatous leprosy with typeⅡleprosy reaction resembling Sweet′s syndrome.The papules and nodules subsided significantly after being treated with corticosteroids and thalidomide.