Pathology Page in Clinical Medicine: Leprosy, Borderline- Tuberculoid Type

Leprosy, or Hansen's disease, is caused by Mycobacterium leprae, causing skin lesions and nerve damage. Less than 5% of people exposed to M. leprae develop clinical disease. Host cell-mediated resistance determines whether an individual will develop paucibacillary or multibacillary disease. We report here the case of a 32-year-old Indonesian male worker with a 3-year history of hypoesthetic erythematous plaque lesions over his right forearm and 10-day history of multiple nontender papules and nodules located in both forearms, back, and face. Neurologic examination showed decreasing tactile sensation over dermatome of the 1st branch of the 5th cranial nerve (also called as ophthalmic nerve). Skin biopsy revealed histiocytic granulomas. Borderline-tuberculoid type of leprosy was diagnosed based on the classical clinical and pathologic manifestations. Although no indigenous case has been reported in Taiwan hitherto, imported case, as shown in this report, can occur.