Image in medicine
Lepromatous leprosy
Lepra lepromatosa
Juan Manuel Gómez-Cerqueraa,
, Sandro Herrera-Dariasa, Anna Domingo-Amelab, Jordi Graells-Estradac
Corresponding author
a Servicio de Medicina Interna, Hospital General Parc Sanitari de Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
b Servicio de Anatomía Patológica, Atrys Health S.A., Barcelona, Spain
c Servicio de Dermatología, Hospital General Parc Sanitari de Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
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Physical examination revealed large, discreetly palpable erythematous plaques with a symmetrical distribution and irregular margins that affected the face, trunk, and limbs (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). The biopsy showed a marked diffuse inflammatory infiltrate with abundant macrophages with vacuolated cytoplasm and eosinophilic material between the collagen fibres. Ziehl–Neelsen staining revealed abundant acid-fast bacilli inside the macrophages, forming granulomas (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B, blue arrows), as well as the accumulation of bacilli inside the macrophages, forming the typical image called “globi” (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B, black arrow), compatible with <span class="elsevierStyleItalic">Mycobacterium leprae</span> infection. Lepromatous leprosy was diagnosed, starting treatment with rifampicin, dapsone and clofazimine for 12 months.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Leprosy is a disease caused by mycobacteria of the <span class="elsevierStyleItalic">M. leprae</span> complex, and is currently a public health problem, with cases reported mainly in South America (with Brazil being the most prevalent country), Africa and Asia. The route of transmission includes the upper respiratory tract, as well as contact with or ingestion of meat from some animals such as armadillos. Clinical manifestations can vary from those limited to the skin or a progressive, disseminated disease known as lepromatous leprosy.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical considerations</span><p id="par0015" class="elsevierStylePara elsevierViewall">This paper has followed all the protocols established in our institution for research work and has the informed consent of the patients involved.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Funding</span><p id="par0020" class="elsevierStylePara elsevierViewall">This research has not received specific support from public sector agencies, the commercial sector or non-profit organisations.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflict of interests</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Ethical considerations" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Funding" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflict of interests" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 553 "Ancho" => 1340 "Tamanyo" => 174933 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015900000011/v2_202301310812/S2387020622005320/v2_202301310812/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015900000011/v2_202301310812/S2387020622005320/v2_202301310812/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622005320?idApp=UINPBA00004N" ]
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