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Lepromatous leprosy and perianal tuberculosis: a case report and literature review.

Parise-Fortes MR, Lastória JC, Marques SA, Putinatti MS, Stolf HO, Marques ME, Haddad V - J Venom Anim Toxins Incl Trop Dis (2014)

Bottom Line: Tuberculosis is predominantly a disease of the lungs; however, it may spread to other organs and cause an extrapulmonary infection.Both mycobacterial infections are endemic in developing countries including Brazil, and cases of coinfection have been reported in the last decade.Nevertheless, simultaneous occurrence of perianal cutaneous tuberculosis and erythema nodosum leprosum is very rare, even in countries where both mycobacterial infections are endemic.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Dermatology, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Botucatu São Paulo State, Brasil ; Departamento de Dermatologia e Radioterapia, Faculdade de Medicina de Botucatu, UNESP, Distrito de Rubião Junior, Botucatu, SP CEP 18618-970, Brasil.

ABSTRACT
Leprosy is a chronic infectious disease caused by Mycobacterium leprae, a microorganism that usually affects skin and nerves. Although it is usually well-controlled by multidrug therapy (MDT), the disease may be aggravated by acute inflammatory reaction episodes that cause permanent tissue damage particularly to peripheral nerves. Tuberculosis is predominantly a disease of the lungs; however, it may spread to other organs and cause an extrapulmonary infection. Both mycobacterial infections are endemic in developing countries including Brazil, and cases of coinfection have been reported in the last decade. Nevertheless, simultaneous occurrence of perianal cutaneous tuberculosis and erythema nodosum leprosum is very rare, even in countries where both mycobacterial infections are endemic.

No MeSH data available.


Related in: MedlinePlus

Cutaneous tuberculosis: fagedenic perianal ulcer.
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Figure 1: Cutaneous tuberculosis: fagedenic perianal ulcer.

Mentions: A 59-year-old male patient was admitted to our university hospital (Botucatu, SP, Brazil) complaining of a perianal suppurative ulcer developed two months before the first medical consultation. He was under therapy with prednisone 40 mg/day for six months due to a presumed diagnosis of a drug reaction. On physical examination, a clean 10-cm diameter phagedenic perianal ulcer (Figure 1) and two longitudinal suppurative ulcers on the inguino-crural region were observed. During investigation, and soon after reducing the corticosteroid dose, disseminated erythematous papules and nodules were observed in the upper limbs (Figure 2).Histopathology of the perianal ulcer revealed a dense histiocytic dermal infiltrate and a granulomatous inflammatory response with central caseous necrosis (Figure 3). Fite-Faraco staining showed a few acid-fast bacilli and the hypothesis of cutaneous tuberculosis was raised. The histopathology of upper limbs papular and nodular lesions showed foamy macrophages with globi of bacilli, suggesting lepromatous leprosy (Figure 4). The perianal and inguinal ulcers were considered uncommon manifestations of type 2 leprosy developed when corticosteroid was gradually diminished. The patient was treated as for multibacillary leprosy with multidrug therapy and thalidomide.


Lepromatous leprosy and perianal tuberculosis: a case report and literature review.

Parise-Fortes MR, Lastória JC, Marques SA, Putinatti MS, Stolf HO, Marques ME, Haddad V - J Venom Anim Toxins Incl Trop Dis (2014)

Cutaneous tuberculosis: fagedenic perianal ulcer.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4150118&req=5

Figure 1: Cutaneous tuberculosis: fagedenic perianal ulcer.
Mentions: A 59-year-old male patient was admitted to our university hospital (Botucatu, SP, Brazil) complaining of a perianal suppurative ulcer developed two months before the first medical consultation. He was under therapy with prednisone 40 mg/day for six months due to a presumed diagnosis of a drug reaction. On physical examination, a clean 10-cm diameter phagedenic perianal ulcer (Figure 1) and two longitudinal suppurative ulcers on the inguino-crural region were observed. During investigation, and soon after reducing the corticosteroid dose, disseminated erythematous papules and nodules were observed in the upper limbs (Figure 2).Histopathology of the perianal ulcer revealed a dense histiocytic dermal infiltrate and a granulomatous inflammatory response with central caseous necrosis (Figure 3). Fite-Faraco staining showed a few acid-fast bacilli and the hypothesis of cutaneous tuberculosis was raised. The histopathology of upper limbs papular and nodular lesions showed foamy macrophages with globi of bacilli, suggesting lepromatous leprosy (Figure 4). The perianal and inguinal ulcers were considered uncommon manifestations of type 2 leprosy developed when corticosteroid was gradually diminished. The patient was treated as for multibacillary leprosy with multidrug therapy and thalidomide.

Bottom Line: Tuberculosis is predominantly a disease of the lungs; however, it may spread to other organs and cause an extrapulmonary infection.Both mycobacterial infections are endemic in developing countries including Brazil, and cases of coinfection have been reported in the last decade.Nevertheless, simultaneous occurrence of perianal cutaneous tuberculosis and erythema nodosum leprosum is very rare, even in countries where both mycobacterial infections are endemic.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Dermatology, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Botucatu São Paulo State, Brasil ; Departamento de Dermatologia e Radioterapia, Faculdade de Medicina de Botucatu, UNESP, Distrito de Rubião Junior, Botucatu, SP CEP 18618-970, Brasil.

ABSTRACT
Leprosy is a chronic infectious disease caused by Mycobacterium leprae, a microorganism that usually affects skin and nerves. Although it is usually well-controlled by multidrug therapy (MDT), the disease may be aggravated by acute inflammatory reaction episodes that cause permanent tissue damage particularly to peripheral nerves. Tuberculosis is predominantly a disease of the lungs; however, it may spread to other organs and cause an extrapulmonary infection. Both mycobacterial infections are endemic in developing countries including Brazil, and cases of coinfection have been reported in the last decade. Nevertheless, simultaneous occurrence of perianal cutaneous tuberculosis and erythema nodosum leprosum is very rare, even in countries where both mycobacterial infections are endemic.

No MeSH data available.


Related in: MedlinePlus