“… 1 , 2 , 3 , 4 , 5 , 6 , 7 It presents with erythematous-brownish papules and nodules, with smooth or rarely umbilicated surface. 1 , 2 , 3 , 4 , 5 , 6 , 7 Due to its unusual clinical features, it is a challenging diagnosis. 1 , 2 , 3 , 4…”
mentioning
confidence: 99%
“… 1 , 2 , 3 , 4 , 5 , 6 , 7 Due to its unusual clinical features, it is a challenging diagnosis. 1 , 2 , 3 , 4…”
mentioning
confidence: 99%
“…The histoid leprosy subtype has been associated with dapsone resistance and mutations of Mycobacterium leprae strains due to inadequate treatment. 1 , 2 , 4 , 7 Currently, there is an increase in cases of the histoid form again. 1 , 2 , 3 , 4 , 5 There is an association with increased cellular and also humoral immunity, absent in lepromatous patients, increasing the number of T lymphocytes locally.…”
mentioning
confidence: 99%
“… 1 , 2 , 4 , 7 Currently, there is an increase in cases of the histoid form again. 1 , 2 , 3 , 4 , 5 There is an association with increased cellular and also humoral immunity, absent in lepromatous patients, increasing the number of T lymphocytes locally. However, bacillary hyperactivity and the attempt to contain the infection, end up weakening the local immune system.…”
mentioning
confidence: 99%
“…However, bacillary hyperactivity and the attempt to contain the infection, end up weakening the local immune system. 1 , 3 , 4 , 6 , 7 The lesions represent a reservoir of Mycobacterium leprae and are extremely infectious. 1 , 2 , 3 , 4 , 5 , 6 , 7 …”
Histoid leprosy is considered a rare form of lepromatous leprosy. Its peculiar clinical picture makes its diagnosis a challenging one, which can delay starting treatment and perpetuate the disease as endemic. In addition to representing a reservoir of bacilli, and being an important means of contamination, these patients have greater resistance to standard treatment. This is a report of a typical case of this rare presentation, aiming to share the knowledge and favor earlier diagnosis of the disease.
“… 1 , 2 , 3 , 4 , 5 , 6 , 7 It presents with erythematous-brownish papules and nodules, with smooth or rarely umbilicated surface. 1 , 2 , 3 , 4 , 5 , 6 , 7 Due to its unusual clinical features, it is a challenging diagnosis. 1 , 2 , 3 , 4…”
mentioning
confidence: 99%
“… 1 , 2 , 3 , 4 , 5 , 6 , 7 Due to its unusual clinical features, it is a challenging diagnosis. 1 , 2 , 3 , 4…”
mentioning
confidence: 99%
“…The histoid leprosy subtype has been associated with dapsone resistance and mutations of Mycobacterium leprae strains due to inadequate treatment. 1 , 2 , 4 , 7 Currently, there is an increase in cases of the histoid form again. 1 , 2 , 3 , 4 , 5 There is an association with increased cellular and also humoral immunity, absent in lepromatous patients, increasing the number of T lymphocytes locally.…”
mentioning
confidence: 99%
“… 1 , 2 , 4 , 7 Currently, there is an increase in cases of the histoid form again. 1 , 2 , 3 , 4 , 5 There is an association with increased cellular and also humoral immunity, absent in lepromatous patients, increasing the number of T lymphocytes locally. However, bacillary hyperactivity and the attempt to contain the infection, end up weakening the local immune system.…”
mentioning
confidence: 99%
“…However, bacillary hyperactivity and the attempt to contain the infection, end up weakening the local immune system. 1 , 3 , 4 , 6 , 7 The lesions represent a reservoir of Mycobacterium leprae and are extremely infectious. 1 , 2 , 3 , 4 , 5 , 6 , 7 …”
Histoid leprosy is considered a rare form of lepromatous leprosy. Its peculiar clinical picture makes its diagnosis a challenging one, which can delay starting treatment and perpetuate the disease as endemic. In addition to representing a reservoir of bacilli, and being an important means of contamination, these patients have greater resistance to standard treatment. This is a report of a typical case of this rare presentation, aiming to share the knowledge and favor earlier diagnosis of the disease.
Histoid leprosy is a rare variant of leprosy with a unique clinical presentation and bacilli rich histology. These patients are large reservoirs for disease and vectors for spread, making prompt diagnosis and treatment crucial. To date, no consensus on treatment and duration exists. This paper aims to investigate the efficacy, safety, and duration of varying treatment regimens in patients with histoid leprosy. A systematic PubMed review of all articles published before January 2020 containing the key words histoid leprosy. All patients included must have completed their prescribed treatments with comment on outcomes and treatment duration. The review generated 165 articles containing 62 cases that met inclusion criteria. A majority of cases reported excellent clinical outcomes with limited adverse events. Regimens included variations of rifampicin, dapsone, clofazimine, minocycline, ofloxacin, and sulforthormadine with most treatment duration lasting 12 or 24 months. Existing literature is limited to case reports or case series and may be subject to publication bias of successful cases. Many reports lack quantifiable data regarding outcomes and rely on clinical judgment. Continued observation for complete clearance or relapse was limited. The findings demonstrate that multibacillary-multidrug therapy is an efficacious and safe treatment for histoid leprosy. No significant differences were observed between 12 and 24 months of treatment. There remains no consensus on treatment duration for histoid leprosy.
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