Multibacillary Leprosy With Tumor Like Nasal Deformity

Authors

  • Ramona Dumasari Lubis Department of Dermatology and Venereology, Faculty of Medicine Universitas Sumatera Utara, Indonesia
  • Mila Darmi Department of Dermatology and Venereology, General Hospital of H. Adam Malik, Sumatera Utara, Indonesia
  • Nani Kumala Dewi Department of Dermatology and Venereology, Faculty of Medicine Universitas Sumatera Utara, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2020.3248

Keywords:

Leprosy, Mycobacterium leprae, Multibacillary, Nasal deformity

Abstract

BACKGROUND: Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae which affects skin, peripheral nerves, and other body parts including bone, ear, eye, and nose. Nasal manifestation of leprosy may be found in the early stage with non-specific symptoms such as nasal congestion. In advanced stage, destruction of bone structures and cartilages may result in deformities. However, nasal manifestation as the only symptom in early stage can lead to delayed diagnosis.

CASE REPORT: We reported a case of multibacillary leprosy in a 26-year-old male with tumor like nasal deformity for 1 year and lump in the ear lobes since 8 years ago. Initially, there was nasal discharge, unfrequent epistaxis, followed by loss of smelling perception, without associated pain, or numbness since childhood. Lesions on the trunk, palms, and soles were also noted since 2 years ago. The physical examination revealed tumor with crusts and fissures on the nasal tip; accompanied by saddle nose. Slit skin smear revealed acid-fast bacilli with bacteriological index of 4+ in solid form. Hence, he was diagnosed as multibacillary leprosy with Grade 2 disability. The prognosis was poor due to permanent deformities.

CONCLUSION: Early diagnosis and initiation of treatment are crucial in the management of this debilitating and stigmatized disease.

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References

Lee DJ, Rea TH, Modlin RL. Leprosy. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology In General Medicine. 8th ed. New York: McGraw-Hill Companies; 2012. p. 2253-63. https://doi.org/10.1111/j.1524-4725.2008.34211.x

World Health Organization. Global leprosy update, 2015: Time for action, accountability and inclusion. Wkly Epidemiol Rec. 2016;91(35):405-20.

Lastoria JC. Leprosy: Review of the epidemiological, clinical, and ethiopathogenic aspects-part 1. An Bras Dermatol. 2014;89(2):205-18. https://doi.org/10.1590/abd1806-4841.20142450 PMid:24770495

Pinheiro RO, de Salles JS, Sarno EN, Sampaio E. Mycobacterium leprae-host cell interactions and genetic determinants in leprosy: An overview. Future Microbiol. 2011;6(2):217-30. https://doi.org/10.2217/fmb.10.173 PMid:21366421

Barton RP. Importance of nasal lesions in early lepromatous leprosy. Ann R Coll Surg Engl. 1975;57(6):309-12. PMid:1108744

Wisnu IM, Sjamsoe-Daili ES, Menaldi SL. Kusta. In: Menaldi SL, Bramono K, Indriatmi W, editors. Ilmu Kesehatan Kulit dan Kelamin. 7th ed. Jakarta: Badan Penerbit Fakultas Kedokteran Universitas Indonesia; 2015. p. 87-102. https://doi.org/10.15395/mkb.v47n4.620

Kesehatan RI, Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan. Pedoman Program Pengendalian Penyakit Kusta. Jakarta: Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan; 2014. https://doi.org/10.20886/jppdas.2019.3.1.79-88

Ramesh V, Kataria JK. Systemic involvement in leprosy. In: Kar HK, Kumar B, editors. Indian Association of Leprologists. Textbook of Leprosy. 2nd ed., Ch. 23. New Delhi; Jaypee Brothers Medical Publisher Ltd.; 2017. P. 331-43. https://doi.org/10.5005/jp/books/12958_24

Kumar B, Dogra S. Case definition and clinical types of leprosy. In: Kar HK, Kumar B, editors. Indian Association of Leprologists. Textbook of Leprosy. 2nd ed., Ch. 15. New Delhi; Jaypee Brothers Medical Publisher Ltd.; 2017. p. 236-53. https://doi.org/10.5005/jp/books/12958_16

Talhari S, de Oliveira CB, Talhari C. Otolaryngological manifestations of leprosy. In: Nunzi E, Massone C, editors. Leprosy. Italy: Springer-Verlag; 2012. p. 255-8. https://doi.org/10.1007/978-88-470-2376-5_24

Sethna KB, Birdi TJ, Antia NH. Adherence of Mycobacterium leprae to the nasal mucosa is influenced by surface integrity and viability. J Biosci. 1997;22(5):575-83. https://doi.org/10.1007/bf02703395

Vora DN, Popat VC, Brahmbhatt V, Sangwan A, Gurnani D, Sinha V. Rhinological evaluation in leprosy. World Articles in Ear Nose Throat. 2012;5(2):5.

Pelle MT. Rosacea. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology In General Medicine. 8th ed. New York: McGraw-Hill Companies; 2012. p. 918-25. https://doi.org/10.1111/j.1524-4725.2008.34211.x

Katz KA. Syphilis. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8th ed. New York: McGraw-Hill Companies; 2012. p. 2471-92. https://doi.org/10.1111/j.1524-4725.2008.34211.x

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Published

2020-04-15

How to Cite

1.
Lubis RD, Darmi M, Dewi NK. Multibacillary Leprosy With Tumor Like Nasal Deformity. Open Access Maced J Med Sci [Internet]. 2020 Apr. 15 [cited 2024 Nov. 23];8(C):19-22. Available from: https://oamjms.eu/index.php/mjms/article/view/3248

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Case Report in Internal Medicine

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