De-Novo Histoid Hansen Cases
A 28-year-old female with 9-month amenorrhea presented with lesions over face, both hands, and legs since 3 months and complaint of epistaxis and nasal stuffiness. Lesions progressed to involve B/L limbs and back.\nThere was no history of fever, joint pain, or loss of chappals. There was no h/o contact with leprosy patients. No h/o any drug intake for leprosy.\nOn examination multiple papulo-nodular lesions with few nodular crusted lesions were present over forehead, earlobes, periorificial area (; Case B), and both upper and lower extremities. Also few discrete hypopigmented patches over buttocks were observed. Both ulnar nerves were thickened. All sensations were slightly altered over both upper and lower extremities over glove and stocking distribution. Corneal and conjunctival sensations were normal. Motor examination was normal. All other routine investigations were normal.\nOn histopathological examination: Section shows thinning of epidermis with collection of macrophages foamy nodules in dermis. Clear grenz zone is evident. Skin adnexa and other dermal appendages are not seen. Heavy bacillary load was seen on Fite Faraco stain []. Split Skin Smear revealed acid-fast bacilli of BI: 6+