Borderline lepromatous leprosy

    The patient WAS a 47 year old male, born in Brazi, who came to USA 3 years ago.
    For more then a year he had recurrent epistaxis and recently developed ulcerating skin lesions. He was evaluated by an outside physician for pancytopenia and underwent a bone marrow biopsy which revealed numerous acid-fast bacilli without granulomas.

    Clinical findings included:

    • mild edema of the hands
    • bilateral lower lateral leg ulcers that are shallow and had no evidence of infection
    • large confluent and monomorphous erythematous plaques without central clearingoverlying the face, trunk, bilateral upper and lower extremities
    • edematous and pendulous ears
    • congested and edematous nose
    • edematous hands and bilateral lower leg erosions
    • no palpable nerves
    • atrophic and sclerotic skin on the  distal extremities

     A biopsy from an ulcer on the ankle was reviewed.

     

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