Rhinophyma in a Patient with Multibacterial Indeterminate Leprosy

Abstract

INTRODUCTION: According to the clinical recommendations, the primacy in diagnosis of leprosy still remains with the laboratory methods, but the disease can also be suspected by the external pathological alterations in the face and limbs. This article presents a case report of one of leprosy masks commonly observed in lepromatous form of multibacterial leprosy (facies leonine), and also shows a combination of leprosy and acne rosacea in the form of rhinophyma.

CONCLUSION: Differential diagnosis did not permit the authors to rest only on the diagnosis of leprosy, because too many details indicated the simultaneous presence of vascular and fibrous alterations of the soft nose tissues uncharacteristic of leprosy, which were diagnosed as a concomitant rhinophyma. The case is indicative as an example of a possible combination of vivid clinical manifestations of two diseases of different nature, which can both hide and imitate each other. 

Keywords

leprosy / leonine facies / madarosis, rhinophyma / Mycobacterium leprae

References

[1] Semyonova VG, Levicheva YY, Shelepova TN, et al. A clinical case of borderline leprosy. Vestnik Dermatologii i Venerologii. 2021;97(6):96–103. (In Russ). doi: 10.25208/vdv1298

[2] Семенова В.Г., Левичева Ю.Ю., Шелепова Т.Н., и др. Клинический случай пограничной формы лепры // Вестник дерматологии и венерологии. 2021. Т. 97, № 6. С. 96–103. doi: 10.25208/vdv1298

[3] Belopasov VV. Typology and pathogenesis of neuropathic pain in leprosy. RMJ. Medical Review. 2018;(9):41–5. (In Russ).

[4] Белопасов В.В. Типология и патогенез нейропатической боли при лепре // РМЖ. Медицинское обозрение. 2018. № 9. С. 41–45.

[5] Awais M, Anwar MI, Iftikhar R, et al. Rosacea — the ophthalmic perspective. Cutan Ocul Toxicol. 2015;34(2):161–6. doi: 10.3109/15569527.2014.930749

[6] Awais M., Anwar M.I., Iftikhar R., et al. Rosacea — the ophthalmic perspective // Cutan. Ocul. Toxicol. 2015. Vol. 34, No. 2. P. 161–166. doi: 10.3109/15569527.2014.930749

[7] Weinkle AP, Doktor V, Emer J. Update on the management of rosacea. Clin Cosmet Investig Dermatol. 2015;8:159–77. doi: 10.2147/ccid.s58940

[8] Weinkle A.P., Doktor V., Emer J. Update on the management of rosacea // Clin. Cosmet. Investig. Dermatol. 2015. Vol. 8. P. 159–177. doi: 10.2147/ccid.s58940

[9] Grigor’ev DV. Rosacea and rosacea-like conditions. RMJ. Dermatology. 2016;(10):627–35. (In Russ).

[10] Григорьев Д.В. Розовые угри и родственные заболевания // РМЖ. Дерматология. 2016. № 10. С. 627–635.

[11] Davydova AV, Bakulev AL, Morrison AV, et al. Molecular mechanisms of rosacea pathogenesis (review). Saratov Journal of Medical Scientific Research. 2013;9(3):561–5. (In Russ).

[12] Давыдова А.В., Бакулев А.Л., Моррисон А.В., и др. Молекулярные механизмы патогенеза розацеа (обзор) // Саратовский научно-медицинский журнал. 2013. Т. 9, № 3. С. 561–565.

[13] Yusupova LA, Yunusova EI, Garaeva ZS, et al. Clinical variations and therapy of patients with rosacea. Lechaschiy Vrach. 2019;(6):77–9. (In Russ). doi: 10.26295/OS.2019.22.16.017

[14] Юсупова Л.А., Юнусова Е.И., Гараева З.Ш., и др. Клинические варианты и терапия больных розацеа // Лечащий врач. 2019. № 6. C. 77–79. doi: 10.26295/OS.2019.22.16.017

[15] Wladis EJ, Adam AP. Immune signaling in rosacea. Ocul Surf. 2021;22:224–9. doi: 10.1016/j.jtos.2021.08.017

[16] Wladis E.J., Adam A.P. Immune signaling in rosacea // Ocul. Surf. 2021. Vol. 22. P. 224–229. doi: 10.1016/j.jtos.2021.08.017

[17] Federal’nyye klinicheskiye rekomendatsii po dermatovenerologii. Dermatovenerologiya 2015: Bolezni kozhi. Infektsii, peredavayemyye polovym putem. Moscow: Delovoy Ekspress; 2016. (In Russ).

[18] Федеральные клинические рекомендации по дерматовенерологии. Дерматовенерология 2015: Болезни кожи. Инфекции, передаваемые половым путем. М.: Деловой экспресс; 2016.

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