DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20210249

An unusual ocular presentation of histoid leprosy

Dhara D. Patel, Arpita H. Solanki, Shankar S. Ganvit

Abstract


Leprosy is a chronic granulomatous infection caused by mycobacterium leprae, mainly affecting the skin and peripheral nerve. Histoid type of leprosy, which is considered as an extremely rare variant of lepromatous leprosy. We report a case of a 50/year old male presented to our institute with chief complain of conjunctival swelling in both eyes, encroaching over cornea and involving limbus and sclera, associated with painless blurring of vision. An incisional biopsy of the right eye was performed under local anesthesia. Histopathology of right eye biopsy revealed spindle shaped cells having bland looking nuclei and variable amount of cytoplasm which was suggestive of histoid leprosy. A dermatology consultation was sought and patient was diagnosed to have leprosy. Consequent to which he was started on MBALD (multibacillary anti leprosy drug), and showed improvement in patient`s visual acuity as well as regression of right eye swelling and disappearance of left eye swelling.  


Keywords


Conjunctival swelling, Histopathological examination, Histoid leprosy

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References


Han XY, Seo YH, Sizer KC, Schoberle T, May GS, Spencer JS, Li W, Nair RG. A new Mycobacterium species causing diffuse lepromatous leprosy. Am J Clin Pathol. 2008;130(6):856–64.

Yanoff M, Duker Jay S. Ophthalmology. 3rd edition. Mosby Elsevier; 2008

Ffytche TJ, McDougall AC. Leprosy and the eye: a review. J R Soc Med. 1985;78(5):397–400

Kanski J, Bowling B. Clinical Ophthalmology - A Systematic Approach. 7th ed. Mosby Elsevier; 2011

Wade HW. The Histoid variety of Lepromatous Leprosy. Int J Leprosy. 1963;31(2):129–42.

Hobbs HE, Choyce DP. The blinding lesions of leprosy. Leprosy Rev. 1971;42(2):131–7.

Mendonca de Barros J. The ocular complications of Leprosy. Am J Ophthalmology. 1946;29(2):162–70.

Reddy SC, Raju BD. Ocular lesions in the inmates of leprosy rehabilitation centre. Int J Biomed Sci. 2006;2(3):289–94.

Acharya BP. Ocular involvement in Leprosy-a study in mining areas of India. Ind J Ophthalmol. 1978;26(2):21–4.

Mansingh N, Chaddah MR. Leproma of the Ciliary Body. Indian J Ophthalmology. 1953;1(2):66–7.

Rathinam S, Prajna L. Hypopyon in leprosy uveitis. J Postgrad Med. 2007;53(1):46–7.

Yuen HK, Liu DT, Lam DS. Corneal leproma as an initial feature of lepromatous leprosy. Arch Ophthalmology. 2006;124(11):1661–2.

Dana MR, Hochman MA, Viana MA, Hill CH, Sugar J. Ocular manifestations of leprosy in a noninstitutionalized community in the United States. Arch Ophthalmology. 1994;112(5):626–9.

Eva C. Kim. Hansen Disease. e-medicine, Ophthalmology. 2010.

Somerset EJ, Sen NR. Leprosy lesions of the fundus oculi. Br J Ophthalmology. 1956;40(3):167–72.

Kaur I, Dogra S, De D, Saikia UN. Histoid leprosy: a retrospective study of 40 cases from India. Br J Dermatol. 2009;160(2):305–10.

Kalla G, Purohit S, Vyas MC. Histoid, a clinical variant of multibacillary leprosy: report from so-called nonendemic areas. Int J Lepr Other Mycobact Dis. 2000;68(3):267–71.