麻风伴Ⅱ型麻风反应1例

A Case of Leprosy with Type Ⅱ Leprosy Reaction

患者男,31岁。全身斑丘疹伴感觉减退十年,全身结节、眉毛、睫毛脱落7年,再发加重7d。曾在本院以"脂膜炎"给予激素、雷公藤等治疗后部分好转,此后多次复发并加重。7d前皮损复发、加重,诊断为"蕈样肉芽肿?淋巴瘤样丘疹病?"。皮损组织病理示:真皮内见大量泡沫状组织细胞,伴肉芽肿形成,抗酸染色可见大量阳性杆菌。最终诊断:麻风伴Ⅱ型麻风反应。转至专科医院进一步诊治。

A 31-year-old male presented with systemic maculopapule accompanied by hypoesthesia for ten years. Systemic tubercles,eyebrow,and eyelash fell off for seven years,and the lesions aggravated for seven days. The patient had been diagnosed as panniculitis in our hospital,and the lesions improved after treatment with corticosteroids and tripterysium glycosides. Since then the lesions relapsed and aggravated many times. The patient was admitted to our hospital and diagnosed as mycosis fungoides or lymphomatoid papulosis. Histopathology showed a large number of foam cell granulomas in the dermis,and acid-fast staining showed a large number of mycobacteria. Leprosy with typeⅡ lepra reaction was diagnosed,and he was transfered to special subject hospital for further treatment.