Lupus vulgaris and borderline tuberculoid leprosy: An interesting co-occurrence

Rao, G Raghurama; Sandhya, S; Sridevi, M; Amareswar, A; Narayana, Betsy L; Shantisri,

doi:10.4103/0378-6323.74997

Cited by 11 publications

(12 citation statements)

References 4 publications

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“…11 Interestingly, many case reports and cohorts studies have been published from the 50s up to the mid-80s reporting the frequent association between TB and leprosy in areas where both diseases were endemic, 12-17 but rarely thereafter. In addition, postmortem studies had previously documented the high incidence of TB as the cause of death in leprosy patients.…”

Section: Discussionmentioning

confidence: 99%

Leprosy and Tuberculosis Co-Infection: Clinical and Immunological Report of Two Cases and Review of the Literature

Trindade¹,

Miyamoto²,

Benard³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Abstract. A review of the records of patients seen between 2004 and 2011 at the Dermatology Clinic of the Sã o Paulo University Medical School showed that only two leprosy patients had been co-infected with tuberculosis (TB). One patient showed a type 1 leprosy reaction during the first 3 months of treatment of pleural TB and in the other patient, pulmonary TB was diagnosed during the first 3 months of treatment of a type 1 leprosy reaction. Both patients showed normal cellular immune response tests, including those of the interferon-gamma (IFN-γ)/interleukin 12 (IL-12) axis. Although both mycobacterial infections are endemic in developing countries like Brazil, the co-infection has hardly been reported in the last decade. There is no suitable explanation for this observation. The reports on the interaction between the two mycobacteria are highly speculative: some studies suggest that leprosy, especially the anergic form, would predispose to TB, whereas other investigations suggested an antagonism between the two diseases.

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Section: Discussionmentioning

confidence: 99%

Leprosy and Tuberculosis Co-Infection: Clinical and Immunological Report of Two Cases and Review of the Literature

Trindade¹,

Miyamoto²,

Benard³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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“…The confusion between leprosy and rheumatic disease has already been reported in the literature [8]. The appearance of “pudgy” deformed fingers is certainly misleading, but it may constitute an unsuspected inaugural form of leprosy, especially in its lepromatous form [9]. The perforating plantar ulcer in our first patient initially evoked a diabetic foot, but its bilateral character and hypertrophy of the ulnar and popliteal nerve trunks helped orient our diagnosis toward leprosy.…”

Section: Discussionmentioning

confidence: 66%

“…In our case, it was 10 years. However, in one study, it was reported that two cases of tuberculosis occurred before leprosy, and it was suggested that tuberculosis can occur together with the full spectrum of leprosy [9]. The interaction between leprosy and tuberculosis and their impact on the incidence of the other remain a subject of debate [10, 13].…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Delayed Diagnosis of Leprosy in Mauritania

Boushab

Fall-Malick

Basco

2018

Case Reports in Dermatological Medicine

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Leprosy is a chronic infectious disease that mainly affects the skin, mucous membranes, and peripheral nervous system. The clinical manifestations of leprosy are numerous and polymorphic with the most frequent signs involving skin and neurological damage. Some of its manifestations, such as joint pain, are unusual. Its elimination as a public health problem in many countries seems to lead to a lack of practical knowledge among health care personnel and as a consequence a risk of late diagnosis. As in other countries, leprosy has become rare in Mauritania. We report two cases of misdiagnosed leprosy in two male patients aged 17 and 65 years. Clinical manifestations included polyarthritis, bilateral plantar perforation, and severely deformed hands and feet in the first case and lichenoid lesions, hypopigmented papules, and unilateral bronchial rales in the second case. The duration of development and persistence of clinical signs before establishment of correct diagnosis was seven to ten years despite the presence of anesthetic, hypochromic maculopapular skin lesions and neurologic signs suggestive of leprosy in both cases. A multilevel chemotherapeutic regimen recommended by the World Health Organization (WHO) was effective, and the patients' condition evolved satisfactorily. The scarcity of leprosy in our health care facilities often leads to a wrong diagnosis. It is imperative to inform physicians to increase their vigilance for appropriate screening and reporting of these cases. The prognosis depends largely on early diagnosis and appropriate treatment.

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“…Simultaneous occurrence of pulmonary tuberculosis with leprosy is known and its incidence in India varies from 2.5 to 7.7% [6, 7]. The association of cutaneous tuberculosis with leprosy is rare and only 11 cases have been reported in English literature to the best of our knowledge (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…A specific cell-mediated immunity mediated by different subpopulations of CD4/CD8 cells helps the two bacilli to coexist and there exists a partial cross-immunity between the two bacilli [7, 10]. CD4+ T cells along with the cytokines IL-12, IFN- γ , and TNF- α play a pivotal role in the control of tuberculosis and leprae infections [10] Coinfection has been explained by the failure of host's T cells to respond to IL-12 in vivo and as a result host's T cells are unable to produce an appropriate Th 1 cell response [10].…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Coexistence of Borderline Lepromatous Leprosy with Tuberculosis Verrucosa Cutis

Dey

Gochhait

Nagendran

et al. 2016

Case Reports in Infectious Diseases

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Occurrence of pulmonary tuberculosis with leprosy is known but association of cutaneous tuberculosis with leprosy is rare. We report a case of borderline lepromatous leprosy coexistent with tuberculosis verrucosa cutis in a 29-year-old male, who presented with multiple skin coloured nodules and hyperkeratotic scaly lesions of 3-month duration. Dual infections are associated with high mortality and morbidity. Therefore early diagnosis and management helps to reduce mortality and to mitigate the effects of morbidity.

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Lupus vulgaris and borderline tuberculoid leprosy: An interesting co-occurrence

Cited by 11 publications

References 4 publications

Leprosy and Tuberculosis Co-Infection: Clinical and Immunological Report of Two Cases and Review of the Literature

Leprosy and Tuberculosis Co-Infection: Clinical and Immunological Report of Two Cases and Review of the Literature

Two Cases of Delayed Diagnosis of Leprosy in Mauritania

A Rare Case of Coexistence of Borderline Lepromatous Leprosy with Tuberculosis Verrucosa Cutis

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