Diagnosis of New Leprosy Patients through Various Histological Findings according to Biopsy Sites.

Abstract

: An 81-year-old male had multiple erythematous to dusky patches on the trunk, arms, and legs for several years (Fig. 1A, B) and two violaceous nodules on the back with unknown onset (Fig. 1C). He had numbness of the hands and feet and edema of the hands and face during the previous six weeks. Punch biopsies were performed on the patch and nodule on the back. The nodule showed dense dermal infiltration by foamy histiocytes and lepra cells containing degenerated microbial components (Fig. 2A, B). The patch showed only superficial dermal perivascular and periappendageal lymphohistiocytic infiltration (Fig. 2C, D). Acid-fast bacillus (AFB) staining revealed that acid-fast bacilli was denser in the nodule than in the patch and some of the bacilli were clustered, forming globi (Fig. 2E, F). The patient was diagnosed as a new lepromatous leprosy patient based on clinical and histological findings. The patient was referred to the Hansen Welfare Association of Korea. Amplication of 154 bp Mycobacterium leprae-specific repetitive element (RLEP) was confirmed in PCR results of Hansen Welfare Association of Korea (Fig. 2G). The institution confirmed that the patient was