Abstract

Histoid Hansen’s is a form of lepromatous leprosy with typical clinical, bacterial morphology and abundant bacillary load. It occurs in lepromatous patients who relapse after dapsone monotherapy, irregular MDT or occasionally denovo. However, the current trend shows a predominant denovo presentation. The present study was conducted to report different clinical features, histological and bacteriological findings in Histoid Hansen’s. METHODS : A prospective case study was conducted in our tertiary care centre over a period of 18 months (January 2022 - June 2023). All clinically suspected cases of Histoid Hansens and those who gave consent were included in the study. Routine blood investigations along with slit skin smear (SSS), skin biopsy were performed to confirm the diagnosis. RESULTS : A total of 10 histoid leprosy cases were enrolled in this study. All were males with age group ranges between 30 - 65 years. 9 out of 10 were denovo cases, 1 presented 2 years after the completion of MB-MDT. Nodules were the commonest skin lesions noted. Ulnar nerve is most commonly affected, in 90% of cases. Slit skin smear revealed abundant organisms. Histopathology was consistent with Histoid Hansen’s. All patients showed clinical clearance of lesions after one year of MB-MDT. CONCLUSION : Histoid leprosy can mimic many other skin conditions. In this study majority of cases were denovo. It is imperative to rise the vigilance in a post global elimination era, to diagnose early, treat in time to prevent transmission.

Description