CLINICAL CASES   

Giornale Italiano di Dermatologia e Venereologia 2001 February;136(1):55-8

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: Italian

Lepromatous leprosy: description of a clinical case

Passarini B., Bandini P., Filacchione C., Lehmann J., Varotti C.

Università degli Studi - Bologna Dipartimento di Medicina Clinica Specialistica e Sperimentale Sezione di Clinica Dermatologica (Direttore: Prof. C. Varotti)

The case of a 52 year-old-man in apparent good health, coming from Southern Italy (Calabria), is described. Since two years he presented red-violet, sharply marginated, painless papules and nodules of various dimension on the whole surface of his body. The histological and electron microscopy examinations showed a granulomatous reaction composed of foamy macrophages. All other examinations (chest X-ray, ultrasonography of abdomen, laboratory parameters), excluded visceral involvement. During hospital permanence, the patient showed a persistent edema of the face and the upper and lower extremities. Sonography of periferal vascularization evidenced bilateral inguinal adenopathy. Lymphnode biopsy was performed. Immunohistochemistry (histiocytes CD68/PG+, MNF 116-), electron microscopy (absence of Birbeck granules), skeleton X-ray (no sign of focal osteolytic lesion) and biopsy of bone, excluded a form of malignant histiocytosis. Staining with Ziehl-Neelsen evidenced numerous acid-fast bacilli. Ultrastructural examination evidenced proliferation of histiocytes and macrophages with vacuoles of amorphus that at higher resolution showed features of bacterial degeneration. Diagnosis of lepromatous lepra was made. The patient was sent to the italian center for the study and therapy of Hansen’s disease. According to personal opinion, this case is particularly interesting since leprosy in Italy has been rarely described. However Italy not is free from leprosy. Cases of this disease are identified as either imported or indigenous.