Atlas of dermatopathology: Leprosy

+ Introduction

+ Literature

+ Support

+ Skin biopsy

+ Non-tumorous skin diseases

+ Skin tumors

+ Mesenchymal tumors

+ Cysts of the skin and subcutis

+ Soft tissue lesions

+ Some lesions of the oral cavity

+ Dermatovenerology

+ Collection of histological slides by prof. Günter Burg

+ Collection of histological slides by prof. Werner Kempf

+ Collection of histological slides of dr. Ram Chandra Adhikari

Leprosy

Etiology

Caused by Mycobacterium leprae; affects the skin and peripheral nerves.

Clinical signs

According to the immunity of the patient, the leprosy can be divided into six forms.

Tuberculoid leprosy, TT in patients with a high degree of immunity, borderline tuberculoid form, BT, true borderline form BL, borderline lepromatous form BL and lepromatous form LL in patients with the least degree of resistence (and this form is further divided into subpolar, LLs and polar, LLp forms.

Leprosy, hands (4179)

Pictures

Lepra, hands: Lepra, hands, Clinical picture (4179)

Further examples of leprosy:

Histology

Epithelioid granulomas with multinuclear Langhans giant cells, usually without necrosis in tuberculoid form. Infiltration and destruction of peripheral nerves is typical.

In lepromatous form there are nodular or diffuse infiltrates consisting of many lymphocytes and macrophages. Nerves are infiltrated as well. No giant cells are present. Later foamy cells appear. Staining for mycobacteria is positive.

For detailed histologic descriptions of various forms of leprosy see specialized literature.

Pictures

Specimens of two patients, suffering from lepromatous leprosy; specimens were taken from the thigh; multiple nodules over the whole body lasting 5 – 6 years; loss of sensation over palms and feet (Anandaban Hospital, Leprosy Mission Nepal, Kathmandu); HE, Fite for mycobacteria: Leprosy lepromatous, HE 60x (10217) Leprosy lepromatous, HE 60x (10218) Leprosy lepromatous, HE 60x (10219) Leprosy lepromatous, HE 60x (10220) Leprosy lepromatous, Fite 60x (13299) Leprosy lepromatous, Fite 60x (13300)

Leprosy (borderline tuberculoid): Leprosy, borderline tuberculoid, HE 20x (4331)

Lepra, tuberculoid: Leprosy tuberculoid, HE 40x (13175) Leprosy, HE 60x (13071) Leprosy, HE 60x (13071) Leprosy tuberculoid, HE 40x (13175)

Erythema nodosum leprosum Erythema nodosum leprosum, HE 60x (14367)

Special staining for acidoresistent mycobacteria Mycobacterium leprae is positive in low resistant patients (Lepromatous leprosy) Mycobacterium leprae, HE (324) Mycobacterium leprae, Fite (317)

Lepromatous leprosy: Lepromatous leprosy, HE (315)

Lepromatous leprosy, detail: Lepromatous leprosy, HE (316)

Tuberculoid leprosy, TT: Tuberculoid leprosy, HE (418)

Tuberculoid leprosy, TT, detail: Tuberculoid leprosy, HE (419)

Another case: Leprosy, HE 2.5x (1393) Leprosy, HE 20x (1392)