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Arch Dermatol. 2005;141:389-394.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Borderline tuberculoid leprosy with a type I downgrading reaction.

MICROSCOPIC FINDINGS AND CLINICAL COURSE

The biopsy specimen demonstrated a moderately dense superficial and deep perivascular and perineural lymphocytic and histiocytic infiltrate. Focal, nonnecrotizing granuloma formations were present. A Fite stain showed the presence of acid-fast bacilli within nerve trunks (Figure 3). The bacterial index was 2 (1-10 bacilli per 1 oil-immersion field). The Ziehl-Neelsen stain was negative for acid-fast bacilli.

Figure appears in full text version. Figure 3.

While there are multiple treatment regimens for multibacilliary disease, we chose the World Health Organization’s system for the treatment of multibacilliary disease. It included a 2-year course of the following: dapsone (100 mg/d, unsupervised [causing eventual elimination of the infection, even if resistant to rifampin]); clofazimine (50 mg/d, unsupervised, and 300 mg monthly, supervised [bacteriostatic]); and rifampin (600 mg monthly, supervised [bacteriocidal, even if resistant to dapsone]). Because of the risk of permanent nerve damage with the downgrading reaction, prednisone therapy (40 mg/d for 2 months) was initiated, followed by . . . [Full Text of this Article]

DISCUSSION

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Arch Dermatol. 2005;141(3):389-394.
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