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© Springer Nature Switzerland AG 2020
S. Kothiwala et al. (eds.)Clinical Cases in Disorders of MelanocytesClinical Cases in Dermatologyhttps://doi.org/10.1007/978-3-030-22757-9_1919. A Young Man with Hypopigmented Macules on Trunk and Multiple Shiny Nodules Over Face
(1)
College of Medicine and JNM Hospital, Kalyani, India
Avijit Mondal
Keywords
Peripheral nerve thickeningAcid fast bacilliLeprosyHansen’s disease Mycobacterium lepraeA 19-year-old male presented to the dermatology OPD with hypopigmented skin lesions on trunk and limbs for 6 months, along with complaints of decreased sensation over both lower legs. Cutaneous examination showed bilaterally distributed multiple hypopigmented and slightly erythematous ill-defined macules, papules and plaques on upper limb and abdomen. There was multiple, soft to firm, dusky erythematous plaques and nodules on the face with similar lesions involving ear (Fig. 19.1). Similar hypopigmented macules, dull red nodules and plaques were seen on back (Fig. 19.2). Bilateral non-tender thickening of ulnar and common peroneal nerves were noted. Loss of sensation of temperature, touch, and diminished pain perception were elicited in both the lower legs along with dryness and loss of hair. There is no history of similar lesions in family members. There was no history of cough or difficulty in breathing. No generalized lymphadenopathy and no organomegaly were found.
Based on the case description and the photographs what is your diagnosis?
- 1.
Post Kala Azar dermal leishmaniasis
- 2.
Lepromatous leprosy
- 3.
Cutaneous lymphoma
- 4.
Sarcoidosis
Diagnosis
Lepromatous leprosy (LL)