PMC4546783_01
A) skin colored papules and nodules on dorsum of hands and posterior aspect of both forearms present at initial presentation of the patient; B) reduced number and size of skin lesions about a month after commencing multidrug treatment for multibacillary leprosy
PAMJ-21-146-g001.jpg
PMC4546783_01_PAMJ-21-146-g001.jpg
F0001
On physical examination, generalized multiple papules and nodules concentrated over the extremities were seen (Figure 1 (A)). She returned for a review about a month after commencing treatment and her lesions had reduced in size and number (Figure 1 (B)), with normalization of her voice.
A) granulomas in dermis extending into fatty tissue; B) Normal epidermis, vacuolation and foam cells in dermis, chronic inflammatory cells also present (H&E, x40); C) Foam cells with bacilli (H&E, x400); D) granulomas with langerhan's giant cells (H&E, x400); E) Mirriads of bacilli (Wade-fite stain, x400); F) Lower epidermis, and cells with multiple bacilli in the upper dermis (Wade-fite, x400)
PAMJ-21-146-g002.jpg
PMC4546783_01_PAMJ-21-146-g002.jpg
F0002
On further staining with wade-fite, multiple bacilli were seen (Figure 2).