Bhagyashree B Supekar; Vrutika H Shah; Jayesh Mukhi; Rajesh P Singh
Abstract
Leprosy, just like syphilis, has become a great imitator with its various atypical and unusual presentations. It presents in many diverse ways and can be confused with many infectious and non-infectious forms.It is often misdiagnosed as common disorders like psoriasis, pyoderma, angioedema, pre-vitiligo, ...
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Leprosy, just like syphilis, has become a great imitator with its various atypical and unusual presentations. It presents in many diverse ways and can be confused with many infectious and non-infectious forms.It is often misdiagnosed as common disorders like psoriasis, pyoderma, angioedema, pre-vitiligo, sarcoidosis, and granuloma annulare. Appropriate history-taking with good clinical examination is required to diagnose atypical presentations of leprosy. Early diagnosis along with appropriate treatment is essential to prevent disability and other complications. We outline a case of lepromatous leprosy with an atypical psoriasiform presentation that mimicked psoriasis. Psoriasiform leprosy presents as erythematous plaques of varying sizes and shapes on the extensor regions of trauma-prone sites like the knees, elbows, and buttocks. This condition mimics psoriasis and is diagnosed as leprosy based on the slit skin smear and histopathology with a special Fite-Faraco stain.
Siti Nurhidayah Pazil; Maryam Mohd Zulkifli; Rosediani Muhamad; Loh Ken Chen
Abstract
The use of highly active antiretroviral therapy (HAART) has prevented opportunistic infections that often lead to death in HIV-positive patients. However, in resource-poor countries, HAART is only initiated at an advanced stage. This could lead to the antiretroviral-induced immune reconstitution syndrome ...
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The use of highly active antiretroviral therapy (HAART) has prevented opportunistic infections that often lead to death in HIV-positive patients. However, in resource-poor countries, HAART is only initiated at an advanced stage. This could lead to the antiretroviral-induced immune reconstitution syndrome or the immune reconstitution inflammatory syndrome (IRIS). The most frequently implicated pathogens associated with these syndromes are mycobacteria, varicella-zoster, herpes viruses, and cytomegalovirus. There are few numbers of case reports of leprosy that have an association with HIV. Meanwhile, lepra reactions are immunological phenomena that can occur before, during, or at the end of multi-drug treatment (MDT). Here, we report the case of a 39-year-old man who presented with four hypoesthetic skin lesions with left ulnar nerve thickening after two months on antiretroviral treatment. He was diagnosed with borderline tuberculoid leprosy as his slit-skin smear showed negative results with four skin lesions and his skin biopsy revealed tuberculoid leprosy with perineural involvement. The patient was started on the paucibacillary MDT regime consisting of dapsone and rifampicin. However, he developed two new hypoesthetic skin lesions over the left gluteal region and left arm, thus being switched to multibacillary MDT. He further developed a type 1 lepra reaction after one month of the regime, though this was successfully treated with prednisolone.
Santoshdev Rathod; Raju G Chaudhary; Tarun Narang
Abstract
Vaccine makers are racing to develop COVID-19 vaccines and have advanced ten candidates into clinical trials. However, vaccine development is typically a lengthy process. A number of immuneresponse modifiers have also been explored for their efficacy in the management of COVID-19. In this ...
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Vaccine makers are racing to develop COVID-19 vaccines and have advanced ten candidates into clinical trials. However, vaccine development is typically a lengthy process. A number of immuneresponse modifiers have also been explored for their efficacy in the management of COVID-19. In this short communication, we explore the possibility of using Mycobacterium indicus pranii (MIP) for the management of severely ill COVID-19 patients and its plausible role in the mitigation of severe disease in mildly infected patients. The MIP vaccine has a proven role in the prevention of leprosy to house-hold contacts of lepromatous leprosy, category-II tuberculosis patients, and patients with severe septicemia and low CD4 counts. It has also been used as an immune response modifier in patients with bladder carcinoma. Notably, this vaccine may be more efficacious than the BCGvaccine. The possible benefits and risks of using such an agent are described in this article. The use of such an approach could be beneficial in resource-poor countries and countries where diseases like tuberculosis and leprosy are endemic.
V Sadeghi; N Maghsoudi; Y Dowlati; AA Deldar; M Heydari Seraj
Volume 8, Issue 5 , 2005, , Pages 388-393
H Tabatabai; M Heydari Seradj
Volume 4, Issue 1 , 2000, , Pages 36-50
Abstract
Dapsone first came into medicine as an antibacterial agent but was found to be less effective than other sulfonamides. Likewise its activity against tuberculosis was disappointing. Nevertheless, it has been the main stay in the treatment of leprosy. It also has some action against malaria and other parasites. ...
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Dapsone first came into medicine as an antibacterial agent but was found to be less effective than other sulfonamides. Likewise its activity against tuberculosis was disappointing. Nevertheless, it has been the main stay in the treatment of leprosy. It also has some action against malaria and other parasites. Nowadays, after leprosy, dapsone has proved as a valuable drug in the treatment of a wide range of mainly uncommon and rare dermatoses. In this article, we present a comprehensive review of the mechanisms of action, pharmacokinetics, uses, adverse reactions and management of side effects of dapsone.
J Gholchye; H Shojaei Tehrani
Volume 3, Issue 1 , 1999, , Pages 5-10
Abstract
Background: Leprosy is a chronic infectious disease endemic in some areas of Gilan province. Objective: To evaluate the knowledge of the personnel employed in Health System Network (Including Behvarzes, Kardans and physicians) on leprosy. Materials and Methods: Questionnaires consisting of 14 multiple ...
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Background: Leprosy is a chronic infectious disease endemic in some areas of Gilan province. Objective: To evaluate the knowledge of the personnel employed in Health System Network (Including Behvarzes, Kardans and physicians) on leprosy. Materials and Methods: Questionnaires consisting of 14 multiple choice questions for Behvarzes and 20 multiple choice questions for Kardans and physicians wee given to 268, Behvarzes 32 Kardans and 27 physicians employed in 4 areas of Gilan province (Roodsar, Rasht, Fooman and Roodbar). The questions included various aspects of leprosy. Results: 72.4% of Behvarzes scored excellent or good for the questions regarding the clinical features and epidemiology of leprosy. But the percentage of correct responses for Kardans and physicians were not satisfactory. Conclusion: The knowledge of Behvarzes about leprosy is enough for the integration of the program of elimination of leprosy in the Health System Network, at least in Gilan province. But further training for Kardans and physicians seems mandatory.
H Tabatabai
Volume 3, Issue 1 , 1999, , Pages 52-57
Abstract
Leprosy is a chronic infectious disease endemic in Iran that mainly involves skin and peripheral nerves. Leprosy has several clinical forms. One of them is “Pure neural leprosy”. The diagnosis of this form is delayed due to lack of clinical signs in other tissues and can lead to permanent ...
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Leprosy is a chronic infectious disease endemic in Iran that mainly involves skin and peripheral nerves. Leprosy has several clinical forms. One of them is “Pure neural leprosy”. The diagnosis of this form is delayed due to lack of clinical signs in other tissues and can lead to permanent deformity. I will discuss my experience for 20 years in the diagnosis and treatment of this form of leprosy and will report a case. Definite diagnosis is usually possible by biopsy of an involved peripheral nerve. Biopsy from uninvolved nerve might give inconclusive results (Sometimes biopsy is taken only from sural nerve) but typical changes of neural leprosy can be found in involved nerves in the same patient. Nerve biopsy can also help in the classification of leprosy and differentiation of leprotic neuritis from neuritis in leprosy reactions. The main complication of nerve biopsy is a local anesthesia of the skin, which usually improves spontaneously. Considering the absence of neurosurgeons in most endemic areas of leprosy, it is recommended to train physicians involved in leprosy treatment to do nerve biopsy.