Atrophy and flattening of epidermis, presence of tuberculoid
granulomas in the dermis and lower layers of epidermis.
The Ridley-Jopling classification of leprosy divides the disease into five groups: tuberculoid
(TT), borderline tuberculoid
(BT), mid-borderline (BB), borderline lepromatous (BL), and lepromatous (LL).
marinum in humans were first reported as a tuberculoid
infection and associated with swimming pools in Sweden in 1939.
Danielssen and Boeck in 1847 classified leprosy into three main clinical types as shown in (Box 2).1 Same authors in 1848 divided leprosy into nodular and anesthetic (Box 2).2 Hansen and Looft in 1895 divided it into tuberosa and maculoanesthetic types (Box 2).3 But, term nodular and maculoanesthetic were used by Kobner.4 Neisser in 1903 described the disease under three forms (Box 2).5 Darier used the term 'tuberculoid
' in relation to leprosy.4
Its clinical spectrum ranges from tuberculoid
leprosy through borderline forms to lepromatous leprosy of the Ridley-Jopling classification .
Biopsy of a representative lesion was performed and the histological examination revealed the presence of tuberculoid
granulomas accompanied by caseation necrosis.
Of these, 13 presented indeterminate leprosy (IL), 15 presented tuberculoid
leprosy (TT), and 15 presented lepromatous leprosy (LL).
Histopathological examinations revealed a granulomatous inflammation with giant cells without caseating necrosis, reported as tuberculoid
Although rare, given its global prevalence, it is imperative for the clinicians to distinguish the many clinical variants of cutaneous tuberculosis and the masquerading infections--granulomatous syphilis, discoid lupus erythematosus, psoriasis, tuberculoid
leprosy, sarcoidosis, actinomycosis, mycetoma, bacterial abscesses, and other skin infections--to preclude missed or delayed diagnosis [2, 3].
leprosy in a woman from the state of Georgia with armadillo exposure.
The infectious causes are Mycobacterium tuberculosis causing tuberculous granulomas both caseating and non caseating, Mycobacterium leprae causing non caseating lepromatous granulomas both tuberculoid
and lepromatous as well as borderline type, Treponema Pallidum causing Gumma in syphilis a microscopic to grossly visible granulomatous lesion composed of sheets of histiocytes, plasma cell and vasculitis.
[2,3] An autoimmune model of tuberculoid
leprosy has been developed, using peripheral nerve as antigen.