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Case Reports
. 2023 Oct 28;15(10):e47859.
doi: 10.7759/cureus.47859. eCollection 2023 Oct.

Lepromatous Leprosy Manifesting As Chronic Macrocheilia: Report of a Rare Case

Rajat Panigrahi  1 , Smita R Priyadarshini  1 , Pradyumna K Sahoo  2 , Tanveer Alam  3 , Shazina Saeed  4 , Shamimul Hasan  5
Affiliations
Case Reports

Lepromatous Leprosy Manifesting As Chronic Macrocheilia: Report of a Rare Case

Rajat Panigrahi et al. Cureus. .

Abstract

Leprosy is a chronic debilitating disorder caused by the acid-fast bacilli Mycobacterium leprae (M. leprae) and Mycobacterium lepromatosis. These bacilli exhibit a distinctive predilection for the skin and peripheral nerves, although they can potentially impact any system in the body. Lately, there has been a notable reduction in mucosal symptoms, largely attributed to the timely diagnosis and treatment of leprosy. Nonetheless, oral lesions continue to hold significant epidemiological importance due to their crucial role in disease transmission. Oral manifestations, although rare, are frequently encountered in individuals afflicted with multi-bacillary leprosy. Chronic macrocheilia is an exceedingly rare manifestation of the disease, with only a few documented case reports and case studies. This article aims to document an exceptionally uncommon case of lepromatous leprosy with chronic macrocheilia as the sole presenting feature.

Keywords: granulomatous disorder; lepromatous leprosy; macrocheilia; oral and maxillofacial pathology; public health care.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Clinical picture of the patient
The clinical picture shows diffuse enlargement of the upper and lower lip with plaque-like lesions (A). The profile view shows diffuse edematous lips (B and C).
Figure 2
Figure 2. Intraoral clinical pictures
Intraoral pictures show enlarged lips with areas of keratosis (A and B).
Figure 3
Figure 3. Histopathological photomicrograph
Photomicrograph showing non-necrotizing epitheloid granulomas with lymphocytes and Langhans-type giant cells around the nerve bundles (arrow mark). H & E staining: A-10x, B-40x.
Figure 4
Figure 4. Wade-Fite staining
Photomicrograph showing numerous acid-fast bacilli (pink color).
Figure 5
Figure 5. A post-treatment picture shows a marked reduction in lip enlargement.
Figure 6
Figure 6. Etiological diagnostic algorithm for chronic macrocheilia
Source: The figure has been created by the authors of this article using the information from Taumi et al. [19]. AFB: acid-fast bacilli; ACE: angiotensin-converting enzyme; GI: gastrointestinal; CT: computed tomography; PCR: polymerase chain reaction
See this image and copyright information in PMC

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