A nine-year clinico-epidemiological study of Histoid Hansen in India

Abstract

Introduction: Histoid Hansen is rare but a well-defined entity with specific clinical, histopathological, and bacteriological features. The incidence has been reported to vary from 1-2% amongst total leprosy patients. Methodology: We performed a retrospective analysis of the records of patients identified as histoid Hansen on the basis of clinico-histopathological criteria, who attended the Hansen clinic from 2000-2009. Results: A total of 962 leprosy patients attended the Hansen clinic from 2000-2009, and of these, 11 (1.14%) were diagnosed as histoid Hansen. The youngest patient on record was 14 years of age. Nearly 70% of the patients were untreated and the rest were on multidrug therapy (MDT) before development of histoid lesions. Three patients showed Erythema nodusum leposum (ENL) reaction. Conclusion: India has achieved elimination of leprosy, but new cases of histoid are still recorded with the same incidence rate. Reactions are not uncommon in such forms, and may be a transition phase to manifest lepromatous leprosy. A thorough knowledge and early detection is needed for this uncommon variant of leprosy which can pose a threat to our elimination drive.

A clinical and histopathological study of histoid leprosy

“…The study by Kaur et al . had an incidence of 1.8%, Mendiratta et al ., 1.14%, and by Kalla et al ., 2.8%, all indicating again the rarity of HL . The male: female ratio of 16 : 1 in this study is much higher than the studies done by Kaur et al .…”

“…The most common sites involved in this study were the upper and lower limbs and trunk, while in the other studies the lower back, thighs, and buttocks were the most common sites involved . However, in the study by Mendiratta et al ., the face was the most common site involved. Earlobe infiltration seen in 58.82% of the cases (Fig.…”

Asymptomatic Skin‐colored Papules and Nodules in a Young Boy

“…The precise etiopathogenesis of HL remains elusive. It may evolve de novo or arise after inadequate and irregular treatment with dapsone monotherapy or multidrug therapy (MDT) . The incidence of HL varies from 1% to 2% of individuals with leprosy .…”

“…HL might represent an exaggerated response to multibacillary disease, which localizes the process. An increase in cell‐mediated and humoral immunity against Mycobacterium leprae , as opposed to lepromatous leprosy (where there is defective cell‐mediated immunity), has been hypothesized . HL is rare in children.…”

De novo histoid leprosy

“…[1] The reported incidence is 1-2% of the total number of leprosy patients,[2] with a male preponderance. It has been described in the age range of 10-84 years.…”