@article{101267,
  keywords = {Leprosy, Woronoff’s Ring, Hypopigmented Halo, Mycobacterium leprae},
  author = {Mushtaq S},
  title = {Erythematous lesions with Woronoff’s ring like perilesional hypopigmented halo in a case of leprosy},
  abstract = {<p><strong>Introduction: </strong>leprosy, a chronic infectious mycobacterial disease caused by M. leprae, presents with a broad spectrum of skin lesions depending upon the type of leprosy. Woronoff’s ring, a hypopigmented halo, is classically observed around resolving psoriatic lesions and is also seen in association with various skin tumors. However, such a phenomenon is rarely reported in leprosy.</p>

<p><strong>Objective:</strong> to describe an atypical case of borderline lepromatous leprosy presenting with Woronoff’s ringlike perilesional hypopigmented halo.</p>

<p><strong>Case description:</strong> the report describes a case of borderline lepromatous leprosy with multiple erythematous lesions over the face, each surrounded by a ring of hypopigmentation. Slit skin smear was positive for acid-fast bacilli, and skin biopsy taken from the facial macular lesion was consistent with the diagnosis. The patient was put on WHO-recommended multibacillary multidrug therapy.</p>

<p><strong>Discussion:</strong> perilesional hypopigmentation, typically associated with psoriatic lesions and certain skin tumors, has rarely been reported in leprosy. The present case was unique due to erythematous lesions with a perilesional hypopigmented halo over the face. Such unusual presentation can lead to a diagnostic dilemma and delay in diagnosis and treatment. Previous literature reports similar findings in isolated cases, suggesting defective melanin transfer or nerve damage as possible causes.</p>

<p><strong>Final consideration:</strong> leprosy can present with atypical manifestations that often pose a diagnostic dilemma. This case emphasizes the importance of comprehensive clinical and cutaneous examination and maintaining a high index of suspicion for leprosy in patients with unusual skin lesions. Timely diagnosis and treatment are crucial to break the chain of transmission in the community.</p>
},
  year = {2024},
  journal = {Hansenologia Internationalis: hanseníase e outras doenças infecciosas},
  volume = {49},
  pages = {1-7},
  publisher = {Instituto Lauro de Souza Lima},
  issn = {1982-5161},
  url = {https://periodicos.saude.sp.gov.br/hansenologia/article/view/40193/38206},
  doi = {10.47878/hi.2024.v49.40193},
  language = {ENG},
}