Patient’s Data erythematous ill-defined

asymptomatic patches (upper extremities, with tingling sensation, numbness of the hands) into multiple erythematous to skin-colored plaques and nodules 1.5x 3.5 to 2.0 x 4.0 cm (malar area, helix of ears, upper extremities, thighs)

(+) leonine facies (-) madarosis

Indeterminate Leprosy

Earliest and mildest form

One to a few of hypopigmented or erythematous macules

Loss of sensation is rare 75% of affected persons

have lesions that heal spontaneously

Most cases progress into a later form, although patients with strong immunity may either clear the infection on their own or persist in this form without progressing.

Patient’s Data erythematous ill-defined

asymptomatic patches (upper extremities, with tingling sensation, numbness of the hands) into multiple erythematous to skin-colored plaques and nodules 1.5x 3.5 to 2.0 x 4.0 cm (malar area, helix of ears, upper extremities, thighs)

(+) leonine facies (-) madarosis

Tuberculoid Leprosy

One erythematous large plaque with well-defined borders that are elevated and that slope down into an atrophic center

Lesions can become arciform or annular

Can be found on the face, limbs, or elsewhere, but they spare intertriginous areas and the scalp

Lesions can be dry and scaly, hypohidrotic, and hairless

Involves a large, asymmetric hypopigmented macule

Patient’s Data erythematous ill-defined

asymptomatic patches (upper extremities, with tingling sensation, numbness of the hands) into multiple erythematous to skin-colored plaques and nodules 1.5x 3.5 to 2.0 x 4.0 cm (malar area, helix of ears, upper extremities, thighs)

(+) leonine facies (-) madarosis

Tuberculoid Leprosy

Spontaneous resolution can occur in a few years, leaving pigmentary disturbances or scars

Progression can also occur, leading to borderline-type leprosy

Neural involvement is common - leads to tender, thickened nerves with subsequent loss of function

Great auricular nerve, common peroneal, ulnar, and radial cutaneous and posterior tibial nerves are often prominent

Nerve damage can happen early, resulting in wrist drop or foot drop

Tuberculoid Leprosy

Patient’s Data erythematous ill-defined

asymptomatic patches (upper extremities, with tingling sensation, numbness of the hands) into multiple erythematous to skin-colored plaques and nodules 1.5x 3.5 to 2.0 x 4.0 cm (malar area, helix of ears, upper extremities, thighs)

(+) leonine facies (-) madarosis

Borderline Tuberculoid

Similar to tuberculoid type except that lesions are smaller and more numerous

Alopecia is less Anesthesis is less

severe Disease may stay in

this stage or convert back to tuberculoid form, or progress to lepromatous leprosy

Borderline Tuberculoid Leprosy

References

http://dermnetnz.org/bacterial/leprosy.htmlhttp://emedicine.medscape.com/article/11049

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