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Clinicopathologic spectrum of Histoid leprosy

Author: 
Punia, R. P. S., Dhingra, H., Baliyan, A., Handa, U., Mohan, H. and Thami, G. P.
Subject Area: 
Health Sciences
Abstract: 

Background: Histoid leprosy (HL) is an uncommon variant of lepromatous leprosy with distinct clinical and histopathological features. Methods: In 10 years (2005-2014), 385 cases of leprosy were diagnosed on histopathology and out of these, 13 cases (3.37%) were of histoid leprosy. Results: The male/female ratio was 2.25:1. 10 cases (76.9%) were in 30-60 year old age group. The commonest skin lesions encountered were nodules over normal looking skin in 10 (76.9%) cases. The most common sites involved were upper and lower limbs in 8 (61.5%) cases. The various clinical differential diagnoses given were leprosy, dermatofibroma, neurofibroma, sarcoidosis, xanthoma, erythema nodosum leprosum and molluscum contagiosum. The main histopathological features were epidermal atrophy and a well-circumscribed dermal area packed with spindle-shaped histiocytes. All the cases were highly positive for acid-fast bacilli. Conclusion: Histoid leprosy usually presents as nodules over a normal looking skin and can have different clinical diagnoses. For confirmation, histopathological correlation is must.

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