100 likes | 450 Views
Tuberculoid (TT) Leprosy. Jaison A. Barreto ILSL, Bauru, S. Paulo, Brazil. Tuberculoid (TT) leprosy: single lesion with central healing and a well-defined, raised and erythematous rim. There is total loss of sensitivity (thermal, pain and tactile), which usually persists after treatment.
E N D
Tuberculoid (TT) Leprosy Jaison A. Barreto ILSL, Bauru, S. Paulo, Brazil leprosy mailing list - November 2011
Tuberculoid (TT) leprosy: single lesion with central healing and a well-defined, raised and erythematous rim. There is total loss of sensitivity (thermal, pain and tactile), which usually persists after treatment. leprosy mailing list - November 2011 Courtesy of: Jaison A. Barreto
TT leprosy: racket lesions Dorsum of the hand: atrophic skin plaque distributed over the area served mostly by the ulnar cutaneous nerve. Dorsum of the foot: enlarged cutaneous nerve (fibularis superficialis) arising from a plaque. leprosy mailing list - November 2011 Courtesy of: Jaison A. Barreto
TT Leprosy (tuberculoid nodular of childhood):note the two painless central points of perforation with fine needle. His grandfather had lepromatous leprosy. Courtesy of: Jaison A. Barreto leprosy mailing list - November 2011
Pure neural tuberculoid leprosy: abscess (a) and thickening (b) of n. fibularissuperficialis. Skin biopsy and skin smears negative. No visible cutaneous lesions. a b leprosy mailing list - November 2011 Courtesy of: Jaison A. Barreto
Pure neural tuberculoid leprosy: fistulized abscesses of the sural nerve. Courtesy of: Jaison A. Barreto leprosy mailing list - November 2011
b a dnb Sc TT leprosy: cord-like tuberculoid granuloma (a), aggression to epidermis (b), partial destruction of Schwann cells (Sc), or almost total destruction of dermal nerve branch (dnb), no bacilli inside granuloma in Faraco-Fite stain. leprosy mailing list - November 2011 Courtesy of: Jaison A. Barreto
TT Leprosy: caseation necrosis of a dermal nerve branch. In this case, deep mycosis or cutaneous tuberculosis must be ruled out, as well as non infectious palisading granulomas. Immunohistochemical assays for S-100 protein can be helpful. leprosy mailing list - November 2011 Courtesy of: Jaison A. Barreto