[P034] Lepromatous leprosy in a immunocompetent patient

Leprosy is chronic granulomatous infection caused by Mycobacterium leprae and affects primarily skin and nerve with variable symptoms and signs. An important factor in leprosy is early diagnosis and prompts initiation of therapy. Because the incidence and newly diagnosed case has decreased over the years, clinicians are often unfamiliar with and can ignored it. Herein, we report a case of lepromatous leprosy in an immunocompetent patient. A 93-year-old woman presented with an asymptomatic, erythematous plaques and subdermal nodules on the face and extremities with tendency of increasing in size and number. The patient had a history of hypertension, cardiovascular disease, osteoporosis and no history of immunocompromised state. A punch biopsy specimen on the face and extremities revealed diffuse infiltration of foamy histiocytes with perineural inflammation separated from the epidermis by a grenz zone. Acid-fast bacilli were seen in Ziehl-Neelsen stain with clumps called golbi. The patient was finally diagnosed as lepromatous leprosy. Following the guideline, she was treated with dapsone 100mg daily and showed clinical improvement.