Chile eliminates leprosy - Pan American Health Organization (PAHO)

Multibacillary lepromatous leprosy can mimic other dermatological conditions, delaying diagnosis. In areas with limited access to histopathology, the slit-skin smear (SSS) is an accessible tool that, together with clinical findings, can support the diagnosis and the start of treatment, while PCR of SSS material may provide complementary confirmation. A 63-year-old male from Montería (Córdoba, Colombia), with a history of chronic venous insufficiency, presented with a two-year history of characteristic skin lesions, including nodular infiltration of the earlobe, a hyperkeratotic plaque with hypoesthesia on the right elbow, and diffuse cutaneous involvement of the chest and abdomen. SSS of the earlobe showed acid-fast bacilli with a bacterial index of 4+ (Ridley scale). Based on the clinical findings and the smear result, multibacillary lepromatous leprosy was diagnosed, and multidrug therapy was started per the WHO regimen without histological confirmation. Real-time PCR performed approximately two and a half months later was positive for Mycobacterium leprae, and a skin biopsy performed about 18 months after diagnosis showed foamy histiocytes consistent with the lepromatous pole. A

Multibacillary lepromatous leprosy can mimic other dermatological conditions, delaying diagnosis. In areas with limited access to histopathology, the slit-skin smear (SSS) is an accessible tool that, together with clinical findings, can support the diagnosis and the start of treatment, while PCR of SSS material may provide complementary confirmation. A 63-year-old male from Montería (Córdoba, Colombia), with a history of chronic venous insufficiency, presented with a two-year history of characteristic skin lesions, including nodular infiltration of the earlobe, a hyperkeratotic plaque with hypoesthesia on the right elbow, and diffuse cutaneous involvement of the chest and abdomen. SSS of the earlobe showed acid-fast bacilli with a bacterial index of 4+ (Ridley scale). Based on the clinical findings and the smear result, multibacillary lepromatous leprosy was diagnosed, and multidrug therapy was started per the WHO regimen without histological confirmation. Real-time PCR performed approximately two and a half months later was positive for Mycobacterium leprae, and a skin biopsy performed about 18 months after diagnosis showed foamy histiocytes consistent with the lepromatous pole. A