Leprosy
A 35 year old male patient resident of ramachandrapuram works as daily wage labourer who is a chronic smoker and alcoholic since 20 years
He came to opd with history of painless lesions which were papules with erythematous base since 3 months which initially started over face and then extended to upper limb and lower limb and also trunk
patient previously got a topical cream soap and some oral drugs from a medical shop and used it for 2 months and few lesions regressed but some persisted on earlobe,hands and trunk
12 days back he developed blackish skin discolouration over hands and feet and there was cracking of skin and ulceration associated with burning sensation
since 1 week patient developed high grade fever associated with chills and rigor which was of continuous type
no known co-morbidities present and no history of similar complaints in the past
on examination:
face:
madarosis-loss of eyebrows
depression of nasal bridge also called as saddle nose
skin of face and earlobe is thickened giving it leonine facies appearance
back:
presence of erythematous nodules and plaques
chest:
presence of variable hypopigmented patches
oral cavity:
palate is dark and erythematous
diagnosis:
lepromatous leprosy in type 2 reaction
investigations:
routine investigations are done
specifc investigations:
split skin smear(sss)
suggestive treatment:
treat the reaction along with multibacillary multidrug therapy
injectable steroids like prednisolone
supportive care
Comme