瘤型麻风误诊1例分析

患者男,38岁。全身反复出现暗红斑3年,伴眉毛脱落、面部数个黄豆大肤色结节3个月余。多次予以抗过敏治疗,红斑可暂时减少,但反复发作。皮损组织病理示:真皮层见大量组织细胞,巢团状,弥漫分布,淋巴细胞少见,组织细胞胞浆空泡状,内见细短杆状的可疑微生物样结构;抗酸染色检查(+)。皮肤组织液查菌结果(2+~5+)。细菌密度指数(BI)4.2。诊断:瘤型麻风。

Analysis of a Case of Misdiagnosed Lepromatous Leprosy

A 38-year-old male presented with recurrent erythema all over the body for three years.He had partial eyebrow hair loss and several soybean-sized nodules on his face for more than three months.After repeated anti-allergy treatment,erythema was temporarily reduced,however,there was repeated attack.Histopathology showed that abundant histocytes in the dermis with nest-like structure,which were diffusely distributed.In addition,lymphocytes were rare,and intracytoplasmic vacuoles were seen in histocytes,with suspicious short-rod-shaped microbial structure.Acid-fast staining assay showed positive results.The result of bacteria detection of skin tissue fluid was 2+~ 5+.The bacterial density index(BI)was 4.2.The final diagnosis was lepromatous leprosy(LL).