Late nodular reversal reaction mimicking relapse: the importance of clinical history and laboratory findings
Vol. 32 No. 2 (2007), Seção anátomo-clínica
Vol. 32 No. 2 (2007)

Late nodular reversal reaction mimicking relapse: the importance of clinical history and laboratory findings

Seção anátomo-clínica
https://doi.org/10.47878/hi.2007.v32.36305
Published 2007-11-30
Jaison Antônio Barreto
Dermatologista e hansenologista “Instituto Lauro de Souza Lima”
Fernanda Chagas de Alencar Marinho
Médica residente “Instituto Lauro de Souza Lima”
Letícia Arsie Contin
Médica residente “Instituto Lauro de Souza Lima”
Maria Esther S. Nogueira
Pesquisadora Científica “Instituto Lauro de Souza Lima”
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Keywords

Borderline leprosy
Type IV Hipersensitivit
Polychemotherapy

How to Cite

1.
Barreto JA, Marinho FC de A, Contin LA, Nogueira MES. Late nodular reversal reaction mimicking relapse: the importance of clinical history and laboratory findings. Hansen. Int. [Internet]. 2007 Nov. 30 [cited 2024 Nov. 23];32(2):197-202. Available from: https://periodicos.saude.sp.gov.br/hansenologia/article/view/36305
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Abstract

A 51 years old man has the diagnosis of borderline leprosy in 2005. On this time he presented 3 honeycombed plaques and some little papules on the back. The histopathology showed active borderline-lepromatous leprosy, bacilloscopy 5+, with viable bacilli. Mitsuda reaction was negative, the dosage of IgM anti-PGL-1 (phenolic glicolipid 1) by ELISA was 0,003 and ML-Flow test (lateral flux test to M. leprae) was negative. Multidrugtherapy (MDT) for multibacillary leprosy was started for 24 months. Nine months after finished treatment, reversal reaction characterized by exacerbation of previous lesions and appearance of multiple erythematous nodules on face, trunk and extremities. The histopathology showed reactional borderline-tuberculoid pattern, with bacilloscopy 1+, granular bacilli. It is discussed the differential diagnosis between relapse and reversal reaction, the reactivation of the disease with multiple nodules mimicking lepromas and the low values of IgM anti-PGL-1 and the negative ML-flow test on the diagnosis.

https://doi.org/10.47878/hi.2007.v32.36305
PDF (Português (Brasil))

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