Case for diagnosis. Erythematous and infiltrated plaques in the infrahyoid region

Abstract

Leprosy is a chronic infectious disease caused by Mycobacterium leprae and, depending on the host immune status, presents different clinical forms. This report describes the case of a 46-year-old man who had hypoesthetic lesions in the infrahyoid region for 30 days. The bacilloscopy was negative. The anatomopathological examination showed alterations corresponding to the tuberculoid pole (epithelioid histiocytes) and virchowian pole (foamy histiocytes), compatible with borderline-virchowian leprosy (Ridley and Jopling classification). Rapid tests for HIV I, II, and syphilis were positive, with a CD4 count of 223. The patient started treatment with multibacillary multidrug therapy, antiretroviral therapy, and benzathine penicillin, with marked clinical improvement in two months.

Epidemiological, clinical, and geographical characterization of Leprosy in the County of Santarém-Pará: Insights for effective control and targeted intervention

“…Regarding the treatment of leprosy patients co-infected with HIV, studies highlight complexities and challenges. It was observed that infection with this virus does not seem to change the incidence or clinical spectrum of the disease, and does not cause changes, or does so discreetly, in the course of leprosy [ 22 , 23 ]. Therefore, the symptoms, reactions and impact of ART and PREP are uncertain in cases of HIV/Leprosy, making it difficult for the patient to adhere to available treatment [ 24 ].…”

Coinfecção HIV e hanseníase: revisão integrativa sobre os desafios do diagnóstico e tratamento

“…A coinfecção entre o vírus HIV e a Hanseníase ainda não possui seus mecanismos de evolução completamente elucidados, porém nota-se que a infecção pelo HIV não provoca alterações, ou as faz discretamente, no curso da hanseníase (Bezerra et al, 2021), entretanto, as reações hansênicas do tipo 1 foram relacionadas ao início do tratamento com Terapia Antirretroviral (TARV) (Torreão, 2020). Sendo assim, os sintomas, as reações e o impacto da TARV são incertos nos casos de HIV/Hanseníase, de maneira a dificultar a adesão do enfermo ao tratamento disponível (Maia, 2019).…”