01548nas a2200145   4500000000100000008004100001100001400042700001400056700001700070245004100087856005100128300001400179490000700193520120200200       2016                            d1 aMaroja MF1 aMassone C1 aSchettini AP00aHistoid leprosy with Type 1 reaction  uhttps://leprosyreview.org/article/87/3/41-7424  a417–4240 v873 a<p>A sixty-one years old man presented with multiple nodules and plaques of different sizes, distributed on the face, trunk, buttocks and lower extremities. He had a history of prior treatment with dapsone monotherapy for Lepromatous leprosy (LL) thirty years ago. The patient was diagnosed with Histoid Borderline-Lepromatous Leprosy after clinical examination and the results of slit skin smears and histopathology that revealed histiocytic granuloma with spindle-shaped, non vacuolated histiocytes. Abundant acid-fast bacilli (AFB) were visible on Fite’s stain. Twelve weeks later, he developed a large erythematous plaque on axillary region and histopathology showed epitheliod and giant cells on background of the histiocytic granuloma. The diagnosis of type 1 leprosy reaction was made and the patient was treated with prednisone at 1 MG/kg body weight/day. The lesions regressed within four weeks and prednisone was slowly tapered (10 mg every 30 days) over four months. The anti-leprosy treatment was stopped after 24 months. Histoid leprosy rarely involves leprosy reactions. More frequently type 2 reactions were reported, but type 1 reactions are also possible as reported here.</p>