Novel presentation of lepromatous leprosy in an erythema gyratum repens‐like pattern

Abstract

Lepromatous leprosy can have varied clinical manifestations and is often a great imitator. However, the skin smear positivity, even in normal skin, symmetrical cutaneous and peripheral nerve involvement, and histopathology in the present patient were indicative of LL. This report highlights a rare presentation of leprosy. Clinicians should be aware of these rare manifestations as lepromatous cases still occur in certain regions.

An erythema gyratum repens variant of bullous lupus erythematosus

“… 2 Other diseases including lepromatous leprosy, limited systemic sclerosis, and psoriasis are reported to present in an EGR pattern. 2 , 7 Finally, there is an entity known as lupus erythematosus gyratus repens, a rare variant of subacute cutaneous lupus erythematosus, which was a diagnostic consideration in this case. In this entity, lesions typically present as widespread, concentric, erythematous plaques, often with double-contoured edges.…”

“… 1 Lesions heal without scarring but often with evident postinflammatory hypopigmentation or hyperpigmentation. 7 …”

Zosteriform multidermatomal nodules and plaques in a case of lepromatous leprosy: an uncommon presentation

“…It has also been established that in anergic leprosy, a bilaterally symmetrical, distribution of hypopigmented macules, nodules or plaques are seen; 1 and while many unusual and protean manifestation of LL have been described, 2-5 a dermatomal presentation is decidedly uncommon. 4,5 Erythema gyratum repens-like pattern 2 Verrucous lesion of lepromatous leprosy 3 Erythema multiforme-like lesion 4 Single plaque on the leg 4 Lymphadenopathy masquerading lymphoma 4 Single nodule on the face 4 Zosteriform, segmental, dermatomal 4,5 Longstanding leg ulcer 4,6 Spontaneous skin ulceration 6 Histoid leprosy 6 Lucio leprosy 6 It has been postulated that this was consequential to the selective multiplication of M. leprae in the nerves of select dermatomes. 7 The sensory fibres of the skin are the first to be affected, and bacilli can be traced in diminishing numbers up the nerve trunks as far as the sensory dorsal root ganglion, but despite extensive search they are not found higher up the cord or in the brain.…”

Bullous pemphigoid resembling erythema gyratum repens – case report

“…According to literature reports, some other conditions can resemble EGR, including: lepromatous leprosy, limited systemic sclerosis, psoriasis, bullous pemphigoid and bullous systemic lupus erythematosus [16,17]. The PubMed database contains reports on a few EGR-like BP cases.…”

“…Według piśmiennictwa EGR może być imitowany przez inne jednostki chorobowe, w tym postać lepromatyczną trądu, limited systemic sclerosis, łusz-czycę, pemfigoid pęcherzowy, toczeń rumieniowaty pęcherzowy [16,17]. W bazie PubMed istnieje kilka opisów przypadków BP przypominającego EGR.…”