REAZIONE REVERSAL QUALE ESORDIO IN GRAVIDANZA DI LEBBRA BORDERLINE TUBERCOLOIDE

A Vietnamese woman that presented an erysipeloid plaque suddenly occurred in the twentieth week of pregnancy on the left half of the face; the lesion was mildly anaesthetic. Histologic examination of a biopsy specimen of the skin showed granulomatous infiltrates mostly composed of epithelioid cells with a wide mantle of lymphocytes into the whole dermis; oedema was present in the papillary dermis. The Fite-Faraco staining revealed scanty acid-fast bacilli (AFB) within a peripheral nerve fibre; the nasal scrape combined with examination of nasal mucus did not show the presence of AFB. Thus, the diagnosis of reversal reaction in borderline tubercoloid leprosy was made and specific polichemotherapy in combination with an appropriate systemic corticosteroid regimen was started. The interest of this case consists in the sudden onset of leprosy presenting as leprosy reaction, but especially in the occurrence of reversal reaction in pregnancy.