01204nas a2200157   4500000000100000008004100001100001600042700001400058700001400072245007500086856005100161300001000212490000700222520080300229022001401032       2016                            d1 aMarahatta S1 aAgrawal S1 aPaudyal P00aDifficult diagnosis and challenging treatment – a report on leprosy.  uhttps://leprosyreview.org/article/87/4/54-3547  a543-70 v873 a<p>Histoid leprosy is an unusual variant of lepromatous leprosy posing difficulties for diagnosis as well as treatment even to the experts. We report a case of a 73 year old male from the hilly region of Nepal, who presented with multiple asymptomatic scrotal nodules for 3 months. Though clinical diagnoses were pilomatricoma and steatocystoma multiplex; histopathological examination was consistent with that of histoid leprosy. After 10 months, he had unusual Type 2 lepra reaction with constitutional symptoms, perichondritis, epididymo-orchitis but without erythema nodosum leprosum. Two years later, his three family members were also affected with leprosy. Hence, this case is reported to highlight the diagnostic dilemma, complicated disease course and infectivity of histoid leprosy.</p>
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