PMC7200790_01
Skin biopsy, H&E stain (low power): Chronic inflammatory cells (mononuclear) infiltrating dermis (yellow solid arrow) and focally into subcutaneous tissue.
gr1.jpg
PMC7200790_01_gr1.jpg
fig0005
Five months later, she started having erythematous nodular lesions over her face, the biopsy of which showed chronic inflammatory cells infiltrating into 30-40 % of the dermis, and extending focally into the subcutaneous tissue (Fig. 1).
Fite Stain, Dermal Nerve infiltrated by AFBs.
gr2.jpg
PMC7200790_01_gr2.jpg
fig0010
Fite stains revealed a moderate number of clumped and intact acid fast bacilli (AFB) within histiocytes as well as within cutaneous nerve twigs (Fig. 2).
Hypopigmented skin patches with hyperemic margin over the back.
gr3.jpg
PMC7200790_01_gr3.jpg
fig0015
Physical examination shows multiple hypopigmented patches with hyperemic margins without much change in sensation over the trunk (Fig. 3).
Left leg: a non-tender, hypo-aesthetic violaceous erythematous geographic skin plaque, which later ulcerated: Possible Lucio's phenomenon.
gr4.jpg
PMC7200790_01_gr4.jpg
fig0020
On her left leg, there was a non-tender, hypo-aesthetic violaceous erythematous geographic skin plaque, which later ulcerated (Fig. 4).
Ridley-Jopling classification of leprosy, which reflects the spectrum of both clinical and pathological features.. TT: tuberculoid; BT: borderline tuberculoid; BB: mid-borderline; BL: borderline lepromatous; LL: lepromatous; LL: lepromatous; AFB: acid fast bacilli.
gr5.jpg
PMC7200790_01_gr5.jpg
fig0025
This patient was diagnosed with Hansen's disease, mid-borderline (BB) with possible type-1 reaction and possible Lucio's phenomenon with peripheral neuropathy in lower extremities (Fig. 5).
PMC7200790_02