de novo Histoid leprosy: an expatriate case recently diagnosed in Johannesburg

Abstract: Histoid leprosy (HL) is a rare variant of lepromatous leprosy with unique clinical, histopathological, and microbiological features. A 32-year-old man from Malawi who immigrated to Johannesburg 1-year-ago, presented with a 4-month history of flesh-colored nodules on the face and trunk and hyperpigmented plaques on the chest and limbs. Skin slit smears confirmed multibacillary leprosy, and skin punch biopsies showed proliferation of spindled cells containing a large number of acid-fast bacilli. The prevalence of de novo HL is increasing in the era of leprosy elimination. HL cases may act as reservoirs and negatively affect the global control of leprosy.

摘要：类麻风（Histoid leprosy，HL）是瘤型麻风的罕见亚型，具有独特的临床、组织病理及微生物学特征。一名来自马拉维、1年前移居至约翰内斯堡的32岁男性，因面部、躯干出现肤色结节，胸部及四肢出现色素沉着斑块，病程已达4个月前来就诊。皮肤刮片涂片确诊为多菌型麻风，皮肤穿刺活检显示梭形细胞增生，胞内含有大量抗酸杆菌。在麻风病消除的时代背景下，新发类麻风的患病率呈上升趋势。类麻风病例可作为传染源，对麻风病的全球防控工作造成负面影响。