Reversal reaction with granulomatous vasculities and necrotizing cutaneous lesions

Authors

  • Consuelo Maria Santos de Albuquerque Nascimento Médica Residente em Dermatologia do 2.º ano do Programa de Residência Médica do Instituto “Lauro de Souza Lima”, Bauru, SP.
  • Raul Negrão Fleury Médico Patologista e Pesquisador Emérito do Instituto “Lauro de Souza Lima”. Doutor em Patologia.
  • Jaison Antônio Barreto Médico Dermatologista e Diretor Técnico do Serviço de Epidemiologia do Instituto Lauro de Souza Lima. Bauru, SP. Mestre em Pesquisas Laboratoriais em Saúde Pública.

DOI:

https://doi.org/10.47878/hi.2006.v31.35215

Keywords:

Leprosy, reversal reaction, granulomatous vasculitis

Abstract

A diagnostic of sub-polar lepromatous leprosy was performed in a 49 years old male. He referred having symptoms for 11 years, mainly neurologic, characteristic of leprosy, but the definitive diagnosis was not performed in any of the previous medical evaluations. After 6 months of multidrugtherapy he presented neuritis treated as type 2 reaction. In a last episode the patient presented with fever, malaise and a crop of necrotic lesions, and ulcerations in the limbs, buttocks, back and left ear. The clinical aspect of these lesions was similar to lesions found in Lucio’s phenomenon and Necrotizing Erythema nodosum leprosum. The biopsies showed changes in the superficial microvasculature and necrosis of dermis and epidermis similar to these reactions, but the basic vascular changes were granulomatous vasculitis in the deep dermis and sub-cutis. The clinical and histopathological features were interpreted as type 1 reaction (reversal reaction) with predominant vascular involvement.

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References

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Published

2006-06-30

How to Cite

1.
Nascimento CMS de A, Fleury RN, Barreto JA. Reversal reaction with granulomatous vasculities and necrotizing cutaneous lesions. Hansen. Int. [Internet]. 2006 Jun. 30 [cited 2024 May 16];31(1):41-6. Available from: https://periodicos.saude.sp.gov.br/hansenologia/article/view/35215

Issue

Vol. 31 No. 1 (2006)

Section

Seção anátomo-clínica

License

This journal is licensed under a Creative Commons Attribution 4.0 International License.

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