RESUMEN
ABSTRACT: Leprosy is a disease caused by Mycobacterium leprae that, depending on a patient's baseline susceptibility and immune system function, can present in a wide variety of ways. The host's immune system response to the infection can be cell-mediated or humoral and can be further altered by changes in immune function or treatment. Depending on the time at which a skin biopsy is taken from affected areas, different inflammatory cell types are present, and the histopathology can mimic that of other infectious, autoimmune, or malignant entities, especially when the clinical information provided is vague. We present a case of a 24-year-old Micronesian woman who initially presented immediately postpartum with clinical and histopathological findings suggestive of urticarial vasculitis, but a subsequent biopsy resulted in a diagnosis of erythema nodosum leprosum reaction and borderline multibacillary leprosy. This case illustrates an unusual clinical and histological presentation of M. leprae and highlights the importance of clinical history.
Asunto(s)
Lepra Dimorfa , Lepra , Urticaria , Vasculitis , Femenino , Humanos , Adulto Joven , Adulto , Mycobacterium leprae , Lepra Dimorfa/diagnóstico , Lepra Dimorfa/tratamiento farmacológicoRESUMEN
Dapsone is regarded as the treatment of choice for linear immunoglobulin A disease (chronic bullous disease of childhood). It is associated with both hemolytic anemia and methemoglobinemia. The hematotoxic effects are dose related and can result in significant hemolysis. We present a case of a patient with chronic bullous disease of childhood and alpha thalassemia trait. Complete resolution occurred on a standard dose of dapsone without significant hemolysis.