Category: Nov 2018 Supplemental Issue Infections

Hypoesthesia and cutaneous eruptions in a patient with T-cell lymphoma: Telltale signs of leprosy, an unrelenting ancient disease

The occurrence of malignant tumors associated with leprosy has been observed,
with lymphoma being the most commonly associated nonepithelial malignant tumor, and may be
due to the depressed immunologic surveillance. The converse where leprosy manifests in a
lymphoma patient undergoing chemotherapy has also been mentioned in a few articles.

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Lepromatous leprosy in type 2 reaction in a primigravid, a case report

Leprosy is a chronic infectious disease caused by Mycobacterium leprae primarily affecting the skin, mucous membranes and peripheral nerves. Pregnancy causes a relative decrease in cellular immunity resulting in first appearance of the disease, reactivation, or relapse in treated patients. Alteration in cell mediated and humoral immunity may trigger leprosy reactions. We report a case of a primigravid in her second trimester of pregnancy diagnosed with lepromatous leprosy in type 2 reaction treated with multidrug regimen and prednisone.

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Crusted Scabies: Presenting as Erythroderma in A Patient with Hepatitis B

Crusted scabies, also known as Norwegian scabies, is a rare and highly contagious clinical variant of scabies infection caused by ectoparasite Sarcoptes scabiei var. hominis. This form of scabies mostly occur in elderly patients with malnutrition, sensory neuropathy, mental retardation, and immunosuppression. In <0.5% of reported cases, crusted scabies may present as erythroderma with erythema and scales on more than 90% of the body surface.

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ROM Therapy in Multibacillary Leprosy Patient: A Report of Three Cases

Leprosy is caused by Mycobacteriom leprae which attacks the peripheral nerves, the skin, the upper respiratory tract mucosa, the other organs except central nervous system. Multibacillary leprosy is characterized by the finding of acid-fast bacili on skin slit smear examination, thickening of more than one nerve, and the presence of more than five lesions. Treatment of leprosy with MDT-WHO decreases the incidence of leprosy. However, long treatment period, resistance, adverse events, and relapse events encouraged the discovery of new treatment regimens. One of the recommended therapeutic regimens of WHO is single-dose ROM (Rifampicin 600 mg, Ofloxacin 400 mg, Monocyclin 100mg) for single PB leprosy. However, some studies have shown the effectiveness of ROM in both PB leprosy and MB.

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A Case of an 18-year-old Filipino Male with Tuberculosis Verrucosa Cutis

Tuberculosis verrucosa cutis is one variant of cutaneous tuberculosis caused by exogenous inoculation of M. tuberculosis at sites of minor wounds or trauma. Lesions usually occur at the upper and lower extremities and buttocks. They initially present as a solitary small asymptomatic papule which slowly expands peripherally leading to hyperkeratotic verrucous plaque with an irregular border. Regional lymph nodes are rarely affected. TVC also does not present with an “apple jelly appearance” on diascopy.

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