La lepra o malaltia de Hansen és una malaltia infectocontagiosa però difícilment . a una altra forma de la malaltia, que serà la forma borderline o dimorfa. dos tipos polares, lepromatosa y tuberculoide, y dos grupos, indeterminada y dimorfa. En esta clasificación se admite que la enfermedad comienza como lepra . Cuatro pacientes presentaron en la biopsia de la recidiva, lepra indeterminada ( LI) y uno lepra dimorfa tuberculoide (LDT), todos con presencia de bacilos.
|Country:||Saint Kitts and Nevis|
|Published (Last):||15 July 2011|
|PDF File Size:||20.49 Mb|
|ePub File Size:||14.73 Mb|
|Price:||Free* [*Free Regsitration Required]|
Anetoderma secondary to borderline leprosy.
To report a case of secondary dimorda in a patient with borderline leprosy and thus draw attention to this unusual association of anetoderma and hanseniasis. Years later, the patient developed “scrolling” surface scars, with a diagnosis compatible with anetoderma lesions secondary to Hansen’s disease. A dermatological affection, although rare, may be associated with common systemic diseases, such as leprosy, and the disclosure of such affections is emphasized in this case.
Their investigation and exclusion are necessary when lepa with such conditions. Anetodermas from the Greek: They have an unknown etiology 4but possible causes include auto-immune mechanisms 5 lupus and sclerodermagenetics causes 6 familial formsinfectious processes 1 chronic atrophying acrodermatitis associated with borreliosis, hanseniasis, syphilis, varicella, and tuberculosisdefects in the synthesis of elastic fibers 7 penicillamine inhibiting lysiloxydase and elastophagocytosis 4.
We report the case of a patient who presented anetoderma lesions secondary to borderline leprosy BLan association that is considered rare. The lesions were asymptomatic and had been growing in number and size Figures 1 and 2. Skin smears were performed for the lesions and were negative for acid-fast bacilli. A biopsy and histopathological exam revealed epidermis with intergemmal crests and dermis presenting a discreet lymphocytic infiltrate around the bases of the superior segment and compact hyaline of the conjunctiva at the inferior segment aspect.
Verhoff staining showed the absence of elastic fibers in all superior dermis, which was compatible with anetoderma.
However, he denied a personal history of lepa, chickenpox or other infectious diseases. Anetodermas, also known as macular atrophies, are characterized by atrophic lesions, which are generally oval or circular, due to the destruction of the elastic dermal tissue.
They may be classified into three groups: They affect men and women equally, and the average age of appearance is 20 years.
Leprosy: the reality for the adolescent
Clinically, they vary from 1 cm to more than 10 cm, and their number varies from a few to hundreds. They are recognized as areas of flat tissue covered with thin, hypochromic and herniated skin that may be protruded due to their flatness 8. They are located in the trunk, arms, and nape and are able to affect the face. Their etiology is unknown, but they are associated with an increase in elastolysis.
Moreover, they have a chronic llepra and a high resistance to treatment 2,9. Anetodermas may be classified as idiopathic Schwenninger-Buzzi anetoderma, idiopathic Jadassohn anetoderma, Pellizari anetoderma, hereditary macular atrophy, which evolves into anetoderma scars with brilliant hypochromic and superficial atrophy 6and secondary anetoderma, which is more frequent 2.
Secondary anetoderma occurs dimodfa patients with anterior cutaneous inflammatory processes, such dimotfa lupus, syphilis, Hansen’s dimoffa, tuberculosis, varicella, and borreliosis 2. In this case, the lesions do not necessarily appear at the same place as the cutaneous manifestation of the associated disease. The diagnosis is essentially clinical and based on anamnesis. It is confirmed by a histopathological exam revealing superficial and profound lymphocytic or vascular infiltrate, with a predominance of lymphocytes.
Epidermal alterations dimoraf not observed, not even in the subcutaneous cellular tissue 7. Granulomas may be found in giant cells in the dermis 7, Diagnostic confirmation requires special staining methods to identify the elastic fibers orcein, Verhoff-Van Giesonelastolysis and elastorrhexis, which affect the papillar and reticular dermis.
The remaining fibers are fragmented, adopting a characteristic tortuous and thin aspect 7. Achenbach et al 9 described a case of anetoderma secondary to polar tuberculoid hanseniasis, and they observed a hypochromic area of 7×5 cm located on the anterior face of the left arm that was protruded, with a hernia and thin skin, which corresponded to the first plaque of polar tuberculoid hanseniasis. When this plaque became involuted after receiving proper treatment, the lesion became anetodermic.
Therefore, despite the rarity of this association, the present case illustrates the aspects of this affection, highlighting the importance of further studies to determine the exact correlations between cytokines and antigens in such associations. This case emphasizes the clinical presentation of a rare dermatological condition and the importance of its recognition and research to exclude the diagnosis of systemic diseases that are sometimes associated.
Primary anetoderma in children: Macular Atrophy of the skin. Primary anetoderma with a wide spectrum of autoimmune abnormalities. J Am Acad Dermatol. Anetodermia secundaria a una lepra tuberculoide polar. Coexistence of disseminated primary anetoderma and generalized granuloma annulare-like papules.
Como citar este artigo.