This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Unknown
Which feature would most likely be found in a patient with lepromatous leprosy? 
Select and explain. 
A. No bacteremia, B. Macrophages with a foamy appearance in the dermis, C. A positive lepromin reaction, D. A high cell-mediated response against Mycobacterium leprae
B: Macrophages with a foamy appearance in the dermis
Answer: B: Macrophages with a foamy appearance in the dermis 
Explanation: The disease of leprosy is divided into two basic types: lepromatous and tuberculoid. The lepromatous form is an aggressive disease, whereas the tuberculoid form tends to be self-limiting. Individuals with lepromatous leprosy have an inflammatory skin infiltrate, which consists largely of macrophages that have a characteris­tic vacuolated or "foamy" appearance (caused by the accumulation of lipids within phagocytes) and intra­cellular acid-fast bacilli. In the lepromatous form, pres­ence of organisms indicates impaired cellular immu­nity, unlike the tuberculoid type, which can effectively kill the bacteria.