01596nas a2200265   4500000000100000008004100001260001300042653001000055653002800065653001100093653002500104653002300129653000900152653001900161100002100180700001600201700001900217700001700236245007600253300001000329490000700339050003200346520093800378022001401316       1988                            d  c1988 Oct10aAdult10aDiagnosis, Differential10aHumans10aLeprosy, lepromatous10aLymphatic Diseases10aMale10aSkin Neoplasms1 aAbdul Razack E M1 aDharmaraj S1 aKrishnaram A S1 aSelvaraj A M00aMulticentric reticulohistiocytosis masquerading as lepromatous leprosy.  a604-80 v60  aInfolep Library - available3 a<p>A 23-year old male presented for evaluation of skin coloured, non-scaly, asymptomatic papulonodules of sizes varying from 0.5 cm to 2 cm of 4 years duration distributed all over the body including the ears. The plaques present on the face gave the appearance of a 'leonine facies'. Clinically mistaken for lepromatous leprosy in reaction the patient was treated with antileprosy and anti-inflammatory drugs in 3 other centres for months with no improvement. Systemic involvement included painful swelling of both knee joints, pericardial effusion episcleritis and enlarged liver. Negative slit smears for AFB from the nodules repeatedly and the histology of one on the skin nodules clinched the diagnosis of multicentric reticulohistiocytosis. The case is reported not only for its rarity, and varying clinical lesions simulating lepromatous leprosy but also to alert the leprologists to avert unreasonable delay in diagnosis.</p>  a0254-9395