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. 2024 Dec 10;12(12):e9697.
doi: 10.1002/ccr3.9697. eCollection 2024 Dec.

Borderline Lepromatous Leprosy With Type 1 Reaction: A Challenging Diagnostic Case

Polanco Llanes Alondra Saray  1 , Zajdman Faitelson Dalit  2 , Figueroa Basurto Carla Itzel  1 , Rodríguez Escamilla Irene Montserrat  1 , Vega Memije María Elisa  2 , Arenas Guzmán Roberto  3
Affiliations

Borderline Lepromatous Leprosy With Type 1 Reaction: A Challenging Diagnostic Case

Polanco Llanes Alondra Saray et al. Clin Case Rep. .

Abstract

Borderline lepromatous leprosy with Type 1 reaction poses significant diagnostic challenges due to overlapping clinical features. Early recognition and differentiation are crucial, especially in endemic regions like Mexico, to ensure prompt, appropriate management and prevent complications. Accurate diagnosis requires a multidisciplinary approach integrating clinical, histopathological, and microbiological data.

Keywords: borderline lepromatous leprosy; case; dermatology; type 1.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
(a, b, and c) Dermatosis affecting the chest, abdomen, back, and the entire circumference of the 4 limbs. It is characterized by multiple plaques with infiltrative appearance, erythematous‐violaceous, with irregular but precise borders and a fine whitish scale on the surface. Some of these plaques converge.
FIGURE 2
FIGURE 2
(a and b) Dermatosis after 2 weeks of treatment with WHO regimen and 40 mg of prednisone. It shows involvement of the chest and back characterized by multiple brown macules with irregular borders, some merging, indicative of hyperpigmentation post inflammatory.
FIGURE 3
FIGURE 3
(a) 4X HE, Histological section of skin showing a multinodular inflammatory infiltrate of variable sizes, predominantly around adnexal structures and vessels (b) 40X HE, The infiltrate is composed of histiocytes with foamy cytoplasm (Virchow cells), as well as some multinucleated giant cells and lymphocytes. (c) 40X Fite‐Faraco stain, highlighting numerous bacilli.
See this image and copyright information in PMC

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