@article{96606, keywords = {Centrofacial eruption, Foamy macrophages, localized multibacillary leprosy, polymerase chain reaction}, author = {Sahni K and Yadav D and Ahuja R and Agarwal S}, title = {Symmetrical Centrofacial Erythematous Plaques and Papules: A Clinicopathological Challenge.}, abstract = {
Facial papular eruptions remain a diagnostic dilemma for the dermatologist with a wide range of inflammatory and infectious conditions manifesting in this manner. Here, we present a case of a 29-year-old, otherwise healthy man from North India with asymptomatic well-defined normoaesthetic symmetrical papules and plaques over the upper and mid-face of 3 months duration. Skin biopsy showed perivascular and periappendageal well-defined collections of foamy macrophages and epithelioid cells in superficial and deep dermis, characteristic of borderline lepromatous leprosy. Though acid-fast stain for lepra bacilli was negative both on lesional biopsy specimen and lesional and ear lobe slit skin smear, a 16s ribosomal ribonucleic acid (16s-r-RNA) polymerase chain reaction on skin biopsy specimen was found to be positive for lepra bacilli. A final diagnosis of borderline lepromatous leprosy in type I reaction was made and the patient received World Health Organization (WHO) multibacillary (MB) multidrug therapy along with oral steroids. This case highlights the unusual localized involvement in a case of MB leprosy lacking all the three cardinal features of leprosy, i.e. sensory loss, peripheral nerve involvement, and acid-fast bacilli positivity on biopsy or slit skin smear but diagnosed on the basis of characteristic histology and positive polymerase chain reaction results.
}, year = {2022}, journal = {Indian dermatology online journal}, volume = {13}, pages = {102-104}, month = {01/2022}, issn = {2229-5178}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8809145/pdf/IDOJ-13-102.pdf}, doi = {10.4103/idoj.IDOJ_66_21}, language = {eng}, }