Leprosy tuberculoides A30.10

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 13.04.2021

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Synonym(s)

leprosy tuberculoids; maculoanaesthetica leprosy; Paucibacillary leprosy; Tuberculoid leprosy; Tuberculoids Leprosy

Definition
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The pauzibacillary tuberculoid leprosy is a relatively benign, usually non-contagious form of leprosy, which develops when the organism is well defended. In this form of leprosy, patients build up a specific immune response. A distinction is made between a minor and a major form.

Localization
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Often in the area where a nerve spreads.

Clinical features
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Skin manifestations: A few, asymmetrically arranged, sharply demarcated, reddish or reddish-purple plaques which enlarge towards the edges and heal centrally with depigmentation and slight atrophy. Sensory disturbances: Initially hyperaesthesia, then mainly centrally loss of temperature, later touch and pain sensation. Anhidrosis. Nerve involvement: Markedly asymmetrical, often ulnar nerve. Facies antonina: facial paresis, ptosis, mimic rigidity. No involvement of internal organs.

  • Minor form: Relatively stable form of tuberculoid leprosy with mildly marked skin lesions, especially near body orifices. Spontaneous regression is possible.
  • Major form: Unstable form. Spontaneous recovery is possible. Frequent transition to leprosy lepromatosa or borderline leprosy of the tuberculoid type. Clinically there is a sunken pale centre; due to centrifugal growth possible formation of ring-shaped plaques, mainly localised on the buttocks, back, face, around the orifices, on the dorsal and lateral parts of the extremities.

Laboratory
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No or only a few bacteria detectable. Lepromine reaction is strongly positive.

Histology
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Epithelioid cell granulomas. S.a.u. Granuloma, tuberculoides.

Therapy
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According to the leprosy.

Progression/forecast
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As in lepromatous leprosy, sensory and motor deficits occur, which are manifested by pareses and secondary muscular atrophy. After healing of the skin lesions, depigmented low-grade atrophic foci can develop.

Literature
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  1. Al-Aboud K et al (2002) Linear cutaneous leishmaniasis occurring on a leg affected by tuberculoid leprosy. Br J Dermatol 147: 1022-1023
  2. Arif T et al (2019) Leprosy in the post-elimination era: a clinico-epidemiological study from a northern Indian tertiary care hospital. Acta Dermatovenerol Alp Pannonica Adriat 28:7-10.
  3. Dogra S (2002) Borderline tuberculoid leprosy and alopecia areata involving scalp. Int J Lepr Other Mycobact Dis 70: 215-216
  4. Karthikeyan K et al (2001) Borderline tuberculoid leprosy with Darier's disease. Indian J Lepr 73: 169-171
  5. Lawn SD et al (2003) Borderline tuberculoid leprosy: an immune reconstitution phenomenon in a human immunodeficiency virus-infected person. Clin Infect Dis 36: e5-6

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 13.04.2021