Health-related quality of life evaluated by Pediatric Quality of Life Inventory 4.0 in pediatric leprosy patients with musculoskeletal manifestations

Neder, Luciana; Weelden, Marlon van; Viola, Gabriela R.; Lourenço, Daniela Mencaroni Rodrigues; Len, Cláudio Arnaldo; Silva, Clóvis A.

doi:10.1016/j.rbre.2015.05.004

Cited by 1 publication

(2 citation statements)

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“…This disease occurs mainly in adults and rarely in children and adolescents. 9,10 The disease presents polar clinical forms: multibacillary lepromatous leprosy and paucibacillary tuberculoid leprosy, as well as borderline forms with hybrid characteristics. 11…”

Section: Discussionmentioning

confidence: 99%

“…The clinical and histological features of borderline tuberculoid leprosy were observed in our case, and this form required paucibacillary therapy (daily doses of dapsone and monthly doses of rifampicin for six months). 9,10 The biopsy is characterized by tuberculoid granulomas, macrophages with epithelioid differentiation and Langhans multinucleated giant cells. Usually, no bacilli are detected in the skin biopsy in this type of leprosy.…”

Section: Discussionmentioning

confidence: 99%

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Borderline tuberculoid leprosy in childhood onset systemic lupus erythematosus patient

Lopes

Lourenço

Guariento

et al. 2015

Lupus

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Leprosy is a contagious and chronic systemic granulomatous disease caused by the bacillus Mycobacterium leprae. To our knowledge, no case of leprosy in a childhood-onset systemic lupus erythematosus (c-SLE) patient has been reported. For a period of 31 years, 312 c-SLE patients were followed at the Pediatric Rheumatology Unit of our University Hospital. One of them (0.3%) had tuberculoid leprosy skin lesions during the disease course and is here reported. A 10-year-old boy from Northwest of Brazil was diagnosed with c-SLE based on malar rash, photosensitivity, oral ulcers, lymphopenia, proteinuria, positive antinuclear antibodies, anti-double-stranded DNA, anti-Sm and anti-Ro/SSA autoantibodies. He was treated with prednisone, hydroxychloroquine and intravenous cyclophosphamide, followed by mycophenolate mofetil. At 12-years-old, he presented asymmetric skin lesions characterized by erythematous plaques with elevated external borders and hypochromic center with sensory loss. Peripheral nerve involvement was not evidenced. No history of familial cases of leprosy was reported, although the region where the patient resides is considered to be endemic for leprosy. Skin biopsy revealed a well-defined tuberculoid form. A marked thickening of nerves was observed, often destroyed by granulomas, without evidence of Mycobacterium leprae bacilli. At that time, the SLEDAI-2K score was 4 and he had been receiving prednisone 15 mg/day, hydroxychloroquine 200 mg/day and mycophenolate mofetil 3 g/day. Paucibacillary treatment for leprosy with dapsone and rifampicine was also introduced. In conclusion, we have reported a rare case of leprosy in the course of c-SLE. Leprosy should always be considered in children and adolescents with lupus who present skin abnormalities, particularly with hypoesthesic or anesthesic cutaneous lesions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%