Erythematous lesions with Woronoff’s ring like perilesional hypopigmented halo in a case of leprosy
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Keywords

Leprosy
Woronoff’s ring
hypopigmented halo
Mycobacterium leprae

How to Cite

1.
Mushtaq S. Erythematous lesions with Woronoff’s ring like perilesional hypopigmented halo in a case of leprosy. Hansen. Int. [Internet]. 2024 Oct. 10 [cited 2024 Dec. 21];49:1-7. Available from: https://periodicos.saude.sp.gov.br/hansenologia/article/view/40193

Abstract

Introduction: leprosy, a chronic infectious mycobacterial disease caused by M. leprae, presents with a broad spectrum of skin lesions depending upon the type of leprosy. Woronoff’s ring, a hypopigmented halo, is classically observed around resolving psoriatic lesions and is also seen in association with various skin tumors. However, such a phenomenon is rarely reported in leprosy. Objective: to describe an atypical case of borderline lepromatous leprosy presenting with Woronoff’s ringlike perilesional hypopigmented halo. Case description: the report describes a case of borderline lepromatous leprosy with multiple erythematous lesions over the face, each surrounded by a ring of hypopigmentation. Slit skin smear was positive for acid-fast bacilli, and skin biopsy taken from the facial macular lesion was consistent with the diagnosis. The patient was put on WHO-recommended multibacillary multidrug therapy. Discussion: perilesional hypopigmentation, typically associated with psoriatic lesions and certain skin tumors, has rarely been reported in leprosy. The present case was unique due to erythematous lesions with a perilesional hypopigmented halo over the face. Such unusual presentation can lead to a diagnostic dilemma and delay in diagnosis and treatment. Previous literature reports similar findings in isolated cases, suggesting defective melanin transfer or nerve damage as possible causes. Final consideration: leprosy can present with atypical manifestations that often pose a diagnostic dilemma. This case emphasizes the importance of comprehensive clinical and cutaneous examination and maintaining a high index of suspicion for leprosy in patients with unusual skin lesions. Timely diagnosis and treatment are crucial to break the chain of transmission in the community.

https://doi.org/10.47878/hi.2024.v49.40193
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Copyright (c) 2024 Sabha Mushtaq

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