CLINICAL CASES   

Giornale Italiano di Dermatologia e Venereologia 2002 June;137(3):211-4

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: Italian

Tuberculoid leprosy: the hyperergic pole of the spectrum. A clinical case

Forgione P. ¹, Barabino G. ², Clapasson A. ², Nunzi E. ²

¹ Clinica Pineta Grande di Castel Volturno - Caserta 2 U.O. di Dermatologia Sociale, Sezione di Dermatologia Tropicale Azienda Ospedaliera Ospedale San Martino - Genova e Cliniche Universitarie Convenzionate

In leprosy, the different cell-mediated immune response identifies a spectrum of clinical forms which vary from the tuberculoid hypergic to the lepromatous anergic. Between these two immunologically stable poles lie three borderline forms whose immunological instability tends to move them in the direction of one of the two poles. A case of tuberculoid leprosy which presented a single lesion in the middle of the forehead is reported. The lesion was characterised by a raised border made up of papules delimiting a central area which presented the colour of normal skin and sensitivity; the border was anaesthetic. Histological examination confirmed the clinical impression of tuberculoid leprosy; Fite-Faraco staining did not reveal resistant alcohol-acid bacilli. Cases of tuberculoid leprosy are rare given the spontaneous evolution of this form towards cure. In Italy in the last ten years the majority of leprosy patients belong to the extracommunitary population; the national reference Centre for Hansen’s disease in Genoa has diagnosed 9 patients with tuberculoid leprosy from sub-Saharan Africa, India and the Philipines out of 73 new cases in the past 10 years.