LAUSR

Results from a slit-skin smear examination from the earlobe revealed the presence of Mycobacterium leprae based on polymerase chain reaction. A diagnosis of HL was made, and the patient was started on World Health Organization–recommended multidrug multibacillary therapy. Histoid leprosy is a rare variant of multibacillary leprosy, first described in 1960 by Wade [1, 2]. The aetiopathogenesis remains unknown, but the condition is proposed to be caused by an exacerbated immune response, which restricts and focuses the infection [3]. Clinically, HL is characterized by indurated, succulent, dome-shaped papules or nodules overlying normal-looking skin, located mainly on the back, hip, face and limbs 5. Erythema nodosum leprosum seems to be more common in the histoid variant, with up to a reported incidence of 75% [2-5]. Histopathologically, the finding of fusiform or spindle-shaped histiocytes, arranged in nodular aggregates together with a storiform pattern, is the typical presentation [3-5]. It is worthwhile including generalised eruptive histiocytosis, papulonodular secondary syphilis and eruptive dermatofibromas as clinical differential diagnoses. Although there are no clear recommendations regarding the treatment of HL, the treatment for multibacillary leprosy is the regimen of choice, which provides successful outcome [2-5].