Lepromatous leprosy of histoid type

Abstract

Histoid leprosy is a variant of lepromatous leprosy, which develops as a result of resistance to dapsone monotherapy. Here we report two cases of lepromatous leprosy of histoid type, one with typical and another with atypical presentations.

Histoid Leprosy

“…Since then few case series have been published, mostly from India 9 It constitutes 1.2-3.6 % of all leprosy cases, however, studies regarding this form of disease are rare. 9,11 This variant of leprosy is considered as a well-recognized expression of multibacillary leprosy characterized by typical clinical, histopathological, immunological and bacteriological findings. 3 Based on the history, physical examination, and supported by laboratory result as well as histopathology, bacteriology and serology examination we diagnosed this patient as Histoid Leprosy.…”

“…Classical lepromatous leprosy presents with generalized symmetric lesions, while histoid lesions presents with localized asymetric lesions. 11 There is no clear recommendation regarding the treatment regimens for histoid leprosy. As some workers have considered it to be a variant of LL disease, it has been treated on the lines of multibacillary leprosy.…”

“…As we have known that ofloxcacin have a strong bactericidal effect like other drugs; minocycline, clarithromycin, and levofloxin. 8,11 It is the general belief that histoid disease requires longer for bacteriological clearance than does LL. 11 According to report of two cases in India, histoid leprosy was managed by initially giving ROM therapy with rifampicin 600 mg, ofloxacin 400 mg, minocycline 200 mg once, which is followed by MDT therapy.1 2 The disease responded satisfactorily.…”

“…8,11 It is the general belief that histoid disease requires longer for bacteriological clearance than does LL. 11 According to report of two cases in India, histoid leprosy was managed by initially giving ROM therapy with rifampicin 600 mg, ofloxacin 400 mg, minocycline 200 mg once, which is followed by MDT therapy.1 2 The disease responded satisfactorily. US National Hansen Disease Program (NHDP) treatment recommends minocycline 100 mg daily, which can be used as a substitution for dapsone in individuals who do not tolerate this drug.…”

Hanseníase históide de localização restrita

“…A aparência queloidiforme é compatível clinicamente com a forma históide, que ocorre nos pacientes multibacilares e está associada à resistência medicamentosa à sulfa e/ou poliquimioterapia, sendo rara em pacientes virgens de tratamento. [3][4][5] A expressão hanseníase históide foi introduzida por Wade, em 1963, com base no aspecto histológico desses hansenomas ricos em bacilos, que são compostos de histiócitos fusiformes similares aos de um dermatofibroma. 3,6 Existem três variantes histológicas do leproma históide: fusocelular puro, fusocelular com componente epitelióide e fusocelular com células vacuolizadas, sendo este último o mais comumente observado.…”