Photogallery. A case of lepromatous leprosy

Leprosy is a chronic disabling disease of infectious nature caused by Mycobacterium leprae hominis and accompanied by lesion of the skin, mucous membranes, peripheral nervous system, musculoskeletal system and viscera. According to the World Health Organization in 2018 208,641 new cases of leprosy have been registered in the world. The major share of morbidity is accounted for countries such as Angola, the Democratic Republic of the Congo, Central African Republic, India, Mozambique, Madagascar, Brazil, Nepal, United Republic of Tanzania. However, due to migration, expansion of trade and economic ties and tourism development, there have been sporadic cases of leprosy in other countries, too. This article describes the illustration of the clinical case of 24-year-old patient S., who turned to our clinic with complaints of rashes on the skin of the face, limbs, auricles of the ears, accompanied by itching. From anamnesis: the patient lived in the Republic of Chad, Central Africa, until 2019, when he moved to Moscow and entered Moscow Institute of Technology, and lived in a dormitory. Patient hasn`t left Moscow since 2019. Comorbidity: chronic viral hepatitis B. According to the patient’s words relatives don’t have complaints. The patient reckons he fell ill about 3 years ago when he noticed rashes on his face the first time. Later on, rashes appeared on the skin of the limbs and body. Over the last year, he has experienced swelling of the hands and the feet. Starting in March 2023, he repeatedly was consulted by dermatologists and haematologists. Among the proposed diagnoses were lichen planus, multiple eruptive xanthoma, non-Langerhans cell histiocytosis (Erdheim–Chestern's disease). Treatment with topical glucocorticosteroids has proved ineffective. Following that the patient visited V.A. Rakhmanov Department of Skin and Venereal diseases, where he was diagnosed with leprosy (multiple hemispherical elevated lepromas on the skin of the body, limbs, face and auricles of the ears, bloody nasal discharge, hypopigmented spots with loss of tactile sensitivity especially on the skin of the limbs, papular rashes on the oral mucosa) and recommended bacterioscopic examination of skin scarificates and nasal mucosa scrapings for detection of Mycobacterium leprae.