01482nas a2200157 4500000000100000008004100001653001200042653003200054653001300086653002800099100001300127700001500140245008300155520107200238022001401310 2018 d10aleprosy10aMid borderline leprosy (BB)10aBlaschko10aBlaschko linear pattern1 aChetan R1 aShailesh M00aMid borderline leprosy in type Bα Blaschko linear pattern: a rare phenomenon.3 a
INTRODUCTION: Leprosy is a chronic granulomatous disease caused by M. leprae. It is a great imitator as it can manifest in different unusual and atypical ways. Mid borderline leprosy (BB) is an unstable form representing the immunologic midpoint in the clinical spectrum.
CASE REPORT: Here, we report a case of BB leprosy having classical inverted saucer-shaped lesions elsewhere on the body with a linear psoriasiform lesion over the left forearm following the lines of Blaschko. Biopsy from this lesion revealed granulomas consisting of equal admixture of epithelioid cells and macrophages without multinucleate giant cells suggesting mid borderline leprosy.
CONCLUSION: Occurrence of lesions in a Blaschko linear pattern supports the role of genetic susceptibility to leprosy. The genetically vulnerable cells along the lines of Blaschko were infected while the surrounding cells remained unaffected. This explains the concept of locus minoris resistentiae due to cutaneous mosaicism.
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