De-Novo Histoid Hansen Cases
A 21-year-old male presented with papular lesions over face since 20 days. He had no complains of fever, epistaxis, or loss of chappals. On examination multiple shiny papulo-nodular lesions were found over forehead, ears, and cheeks (; Case 3). Nasal stuffiness, congestion, and watering from eye present.\nBilateral ulnar nerve, greater auricular nerve, common peroneal nerve, anterior tibial nerve, posterior tibial nerve were thickened. Glove and stocking anesthesia present upto elbow and knee. Corneal and conjunctival sensations were normal. Motor examination was normal. All routine investigations were normal.\nOn histopathological examination: Section shows extensive cellular infiltration in dermis mainly composed of macrophages, lymphocytes, and plasma cells. There are clear Grenz zones below the flattened epidermis. Hematoxylin and eosin-stained sections showed classical histocytic Granulomas [] with heavy bacillary load on Fite Faraco stain. Split Skin Smear revealed acid-fast bacilli of BI: 6+ [].