HANSEN’S DISEASE DIAGNOSED AFTER ANTI-CANCER CHEMOTHERAPY

(case report)

Keywords: histoid leprosy, acid fast bacilli, multi drug therapy

Abstract

Background. Leprosy or Hansen’s disease is a chronic granulomatous disease involving predominantly skin, peripheral nerves and nasal mucosa but capable of affecting any tissue or organ. Histoid leprosy is a very rare well-defined clinicopathological variant of multibacillary lepromatous leprosy, which is very difficult to diagnose due to different specific clinical and histopathological findings that mimic a fibromatous disorder. Histoid leprosy occurs generally after treatment failure and sometimes de novo.

Objective. The aim of the study was to explore histoid leprosy throughout a case report.

Methods. A case report of histoid leprosy diagnosed after cancer chemotherapy is presented.

Results. A 25-year-old healthy male presented with multiple skin coloured, discrete, well defined, painless papules and nodules scattered over nape of neck, right side of the trunk and both arms along with numbness as well as tingling sensation over both the arms and trunk. It was a case of non-seminomatous germ cell tumour (NSGCT), left testis, diagnosed and treated with a high inguinal orchidectomy with adjuvant chemotherapy in 2016. Ziehl Neelsen (ZN) stain for Acid Fast Bacilli (Mycobacterium leprae) – a modified Fite stain method showed numerous acid-fast bacilli. Histopathological diagnosis of Hansen’s disease (Histoid) was conducted. The patient was admitted and started on triple drug multi-bacillary multi-drug therapy (MB-MDT). A remarkable improvement was noticed in the lesion status within one month of institution of the therapy.

Conclusions. Histoid leprosy is a discrete infrequent form of multibacillary leprosy with distinctive clinical, bacteriological and histomorphological features. Histopathologic examination with modified Fite stain is still the mainstay of diagnosis.

Author Biographies

S. A. Hashmi, ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA

Dr. Syed Asif Hashmi, Assistant Professor Pathology, Army College of Medical Sciences and Base Hospital, New Delhi 110010, India

G. S. Bhadauria, ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA

Resident Microbiology, Army College of Medical Sciences and Base Hospital, New Delhi 110010, India

K. S. Rajmohan, ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA

Senior Advisor and Head (Pathology and Neuropathology), Army College of Medical Sciences and Base Hospital, New Delhi 110010, India

I. D. Khan, ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA

Associate Professor, Clinical Microbiology and Infectious Diseases, Army College of Medical Sciences and Base Hospital, New Delhi 110010, India

A. Gupta, ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA

Assistant Professor Pathology, Army College of Medical Sciences and Base Hospital, New Delhi 110010, India

D. Mitra, ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA

Associate Professor Dermatology, Army College of Medical Sciences and Base Hospital, New Delhi 110010, India

R. M. Gupta, ARMED FORCES MEDICAL COLLEGE, PUNE, INDIA

Dean and Deputy Commandant; and Professor Microbiology,Armed Forces Medical College, Pune 411040, India

M. Rahman, BUDDHA INSTITUTE OF DENTAL SCIENCES, INDIA

Consultant Dentist, Buddha Institute of Dental Sciences, India

U. Kapoor, COMMAND HOSPITAL (NC), UDHAMPUR, INDIA

Professor and Head Pathology, Command Hospital (NC), Udhampur 182101, India

S. K. Singh, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI, INDIA

Pathologist and Senior Resident Nephropathology, All India Institute of Medical Sciences, New Delhi, India

F. M. H. Ahmad, ARMY COLLEGE OF MEDICAL SCIENCES AND BASE HOSPITAL, NEW DELHI, INDIA

Professor Internal Medicine and Neurology, Army College of Medical Sciences and Base Hospital, New Delhi 110010, India

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Published
2020-02-18
How to Cite
Hashmi, S. A., Bhadauria, G. S., Rajmohan, K. S., Khan, I. D., Gupta, A., Mitra, D., Gupta, R. M., Rahman, M., Kapoor, U., Singh, S. K., & Ahmad, F. M. H. (2020). HANSEN’S DISEASE DIAGNOSED AFTER ANTI-CANCER CHEMOTHERAPY : (case report). International Journal of Medicine and Medical Research, 5(2), 20-24. https://doi.org/10.11603/ijmmr.2413-6077.2019.2.10458