Diffuse leprosy with "deck-chair" sign

Abstract

A 55-year-old male presented with asymptomatic extensive skin lesions since one year. He was found to have diffuse lesions involving the face, trunk, arms, and thighs along with symmetric peripheral nerve thickening. Bacteriological and histopathological examination confirmed lepromatous leprosy. There was a conspicuous sparing of the abdominal creases and axillae from the infiltrative lesions suggesting a positive “deck-chair” sign. This sign has been described in the past with papulo-erythroderma of Ofuji and certain other disorders. Leprosy may be now included among the causes of “deck-chair” sign.

Physician, beware! The deckchair sign can be seen in dermatomyositis

“…Attributed causes included mycosis fungoides, atopic dermatitis, idiopathic erythroderma and psoriasis . Other reported associations include contact dermatitis, Waldenstrom macroglobulinaemia, generalized acanthosis nigricans and leprosy . It remains uncertain whether OP should be considered a separate entity or solely a presentation of other diagnoses …”

“…postulated a relationship to photoexposure, based on the sparing at unexposed sites of all patients in their series noted to be outdoor workers . In leprosy, DCS is thought to occur due to the mycobacterium sparing warmer areas of the body . Other authors have questioned whether compression of the skin layers could reduce inflammation .…”

Erythroderma as a manifestation of leprosy

“…The diagnosis of leprosy is based on clinical, bacilloscopic and histological evidence. 6 These results led to the diagnosis of borderline lepromatous leprosy.…”

Papuloerythroderma with Associated Non Hodgkin’s Lymphoma : A Rare Entity

“…3 Deck chair sign, though being highly characteristic of papuloerythroderma of Ofuji, is also seen in certain other diseases such as erythroderma secondary to atopic dermatitis and psoriasis, acanthosis nigricans, leprosy, contact dermatitis or may be idiopathic. 2,4 Associated clinical and hematological features include lymphadenopathy, peripheral eosinophilia, and raised serum IgE level. 5 After about 25 years of the disease description by Ofuji, Torchia et al reviewed the literature of 170 cases of papuloerythroderma of Ofuji and gave the diagnostic criteria as outlined in table 1.…”