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Case Reports
. 2014 Jan;5(1):59-62.
doi: 10.4103/2229-5178.126035.

Hansen's disease associated with erythromelalgia mimicking Lupus erythematosus

Shenoi Shrutakirthi Damodar  1 , Prabhu Smitha  1 , Balakrishnan Nirmal  1 , Nayak U K Sudhir  1 , Pai Sathish Ballambat  1
Affiliations
Case Reports

Hansen's disease associated with erythromelalgia mimicking Lupus erythematosus

Shenoi Shrutakirthi Damodar et al. Indian Dermatol Online J. 2014 Jan.

Abstract

Hansen's disease, though considered to be at the verge of elimination in many countries including India, still continues to surprise patients and dermatologists alike. This is mainly due to its varying and unconventional presentations which may lead to initial misdiagnosis and prolongation of treatment. Here we describe an unusual case presenting with erythematous photosensitive facial lesions associated with erythromelalgia of the finger tips, provisionally diagnosed as SLE. A subsequent histopathology examination proved it to be Hansens' disease Borderline Tuberculoid variety. Hansen's disease can be termed as the modern great imitator, displacing the traditional great imitator, syphilis.

Keywords: Erythromelalgia; Hansen's disease; Lupus erythematosus; histopathology.

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Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Erythematous plaques over the face at presentation
Figure 2
Figure 2
Erythema over finger tips at presentation
Figure 3
Figure 3
Histopathological specimen – H and E,×10 stain showing attenuated epidermis with a grenz zone and dermis containing ill-defined collections of lymphocytes, macrophages and epitheloid cells in a perineural, periadnexal and perivascular location
Figure 4
Figure 4
Histopathological specimen – H and E, ×40 showing periappendageal concentration of inflammatory cells consisting of lymphocytes, epithelioid cells and macrophages
Figure 5
Figure 5
Fite stain showing acid-fast bacilli (marked with arrow)
Figure 6
Figure 6
Two months post-treatment with antileprosy therapy showing resolution of facial plaques
See this image and copyright information in PMC

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