Case Report

Leprosy Reaction

Presented by: Rulita Aprilya A

Supervisor: dr. Irma Tarida L, Sp.KK

Department of Dermatology and Venereology

Mardi Waluyo Public Hospital, Blitar
Faculty of Medicine, University of Islam Malang
2018
IDENTITY
• Name : Mr. MI
• Age : 20 years old
• Sex : Male
• Adress : Blitar
• Job : Student
• Religion : Islam
• Marriage Status : Single
• Examination Date: October 10th, 2018
HISTORY
• This patient has not been treated
Physical Examination

 General Condition
Good condition
 Consciousness
Compos mentis, GCS 4 5 6
 Vital Sign
Pulse : 88 x/menit,
RR : 20 x/menit,
Tax : not performed
Physical Examination

• Head to Toe
1. Eyes : normal
2. Thorax : cor dan pulmo normal
3. Abdomen : soefl, bowel sounds (+), timpanyc,
tenderness (-)
4. Extremities : swelling extremities (-/-)
 Physical Examination
• Dermatology status

Face, both ears, hands, and legs area :

Swelling, eritematous, not painful

The lesions were accompanied with thickening of bilateral great auricular nerves, bilateral u
lnar nerve and bilateral lateral peroneal nerves
Slit skin smears
(Ziehl-Neelsen stain)

acid-fast bacilli : +5
DIAGNOSIS
PLANNING TREATMENT
 History
Case
• Swelling on the hands, face, ears, and legs,,
eritematous, not painful; started about a
month and a half ago
• Thickening of bilateral great auricular
nerves, bilateral ulnar nerve and bilateral
lateral peroneal nerve
• Ziehl-Neelsen stain were founded acid-fast
bacilli : +5 on mycroscope
Theory
• Sudden appearance of symptoms
• Swelling of the limbs &/or face may be present
• Erythema and swelling of skin lesions without ulceration
• Nerve function may get affected without any pain or
tenderness
• Existing involved or new nerves become enlarged
• General condition of the patient: Good, with little or no fever
• Skin smear positive for AFB
Differential Diagnosis

• Palmar Abscess
– when more is warmth, tenderness and oedema of the extremities

• Urticarial
– It is an acute evanescent circumscribed oedema that usually affe
cts the lips, ear lobes and the mucous membranes of the mouth
Conclusion
• This patient was diagnosed “Leprosy Reaction” because `apropriate
with the theory of leprosy reaction.

• The results of Ziehl-Neelsen stain were founded acid-fast bacilli : +5

on mycroscope

• Leprosy reaction can treated with multiple drug theraphy:

– Once a month: Rifampicin 600 mg, Dapsone 100 mg, Lampren 300 mg
– Once daily: Dapsone 100 mg, Lampren 50 mg daily
– Twice daily: Neurodex
THANK YOU