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hiperpigmented macules and patchs on the face&#44; trunk and limbs that respect palms&#44; soles and mucosa&#44; with malaise&#44; paresthesias in upper limbs and thickening of ulnar nerves &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#44; B&#41;&#46; Bacilloscopy was positive in the ear &#43;&#43;&#44; elbow&#8239;&#43;&#8239;and knee &#43;&#46; The histopathological study shows fusiform histiocytes with a tendency to nodularity and identifies acid-alcohol resistant bacilli intracytoplasmic in macrophages&#44; compatible with histoid leprosy &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C&#44; D&#41;&#46; The patient is being treated with MDT and we added minocycline 100&#8239;mg with good clinical response by decreased size and disappearance of some nodules at the third month&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The second case is a 52 years-old male with no relevant personal history who presents asymptomatic generalized skin color nodules&#44; mainly localized in trunk and proximal limbs &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#44; B&#41;&#46; The bacilloscopy was positive in the ear &#43;&#43;&#44; elbow &#43;&#43; and knee &#43;&#46; The biopsy shows a thinned epidermis with a Grenz zone and diffuse dermal proliferation of epithelioid-vacuolated histiocytes with fusiform cells and moderate lymphocytic infiltrate&#46; Virchow historiocytes are also around the nerves &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>C&#41;&#46; Wade-Fite stain shows globus and isolated acid resistant bacilli&#44; which confirms the diagnosis of histioid leprosy &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>D&#41;&#46; The patient is being treated with WHO MDT&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">By 2003 leprosy had been eliminated from 117 countries&#44; but the disease continues to present a public health problem in 17 countries&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> It remains an enigmatic form of leprosy mostly reported from India&#44; Brasil&#44; Birmania and constitutes 1&#44;2-3&#44;5&#37; of all leprosy cases&#44; with male predominance in age range of 20-50 years&#59; however&#44; studies regarding this form of disease are very rare&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;4</span></a> HL has been reported generally to manifest in patients after long-term dapsone monotherapy&#44; irregular or inadequate therapy&#44; there are also reports of disease developing as relapse after successful treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> However&#44; de-novo cases of HL have also been encountered&#44; as our second case&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The etiopathogenesis of this entity is not clear&#44; but has been suggested to represent a hyperactive expression of multibacillary leprosy in an effort to restrict or focalize the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The interplay of genetic factors&#44; immune response and treatment received in a given patient seems to influence the manifestations of HL&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> According to Sehgal et al&#46; probably some groups of histiocytes work different from others&#44; this would explain why a combination of ordinary lepromas and histoid nodules can be found in the same patients&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The most accepted theory is that proposed by Civatte&#44; who pointed out that the histiocyte grows slowly and begins to produce large amounts of collagen under an unknown stimulus&#46; This hyperplasia produces an inflammatory process that subsequently results in the formation of a nodule&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Clinically the histoid lesions appear as smooth&#44; shiny&#44; erythematous or coppery color&#44; dome-shaped&#44; nontender soft to &#64257;rm nodules which may be super&#64257;cial or subcutaneous and plaques appearing on otherwise normal looking skin&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> The localization is usually on the posterior and lateral aspects of the arms&#44; buttocks&#44; thighs&#44; dorsum of the hands&#44; lower part of the back&#44; and over the bony prominences&#44; especially over the elbows and knees&#46; Lesions vary in size and consistency&#44; usually of 1&#46;5-3 cm&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Mendiratta et al&#46; and Nair and Nanda Kumar have reported frequencies of erythema nodosum leprosum &#40;ENL&#41; among HL cases of 40&#37;&#44; 27&#37; and 24&#37; respectively&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;9</span></a> It has been proposed that ENL probably occurs in patients during the transition to manifest HL&#44;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> as our first case&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The instant confirmation of histoid leproma is made with smears test&#44; which has a specificity of 100&#37; and a sensitivity of 50&#37;&#44; and can be obtained from nasal mucosa&#44; an ear lobe or skin lesions&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Histopathological &#64257;ndings are unique&#44; epidermis may be normal or atrophic with a Grenz zone&#46; The leproma consists of fusiform histiocytes arranged in a whorled&#44; criss-cross&#44; or storiform pattern&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Within the histiocytes&#44; plenty of acid fast bacillus can be found&#46; They are longer than the normal bacilli&#44; are uniform in length and are arranged in parallel bundles along the long axis of the spindle histiocytes with or without globus formation&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In addition the factor XIIIa positive is characteristic and the loss of S100 expression&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">It has been treated on the lines of multibacillary leprosy with the recommended WHO MDT&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Researchers have also managed initially by giving the range of motion therapy&#44; with rifampicin 600&#8239;mg&#44; o&#64258;oxacin 400&#8239;mg&#44; and minocycline 200&#8239;mg&#44; which is followed by MDT&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">To conclude&#44; it is important to recognize atypical leprosy presentations to continue the surveillance for new cases&#44; since early diagnosis and complete treatment are important to achieve our goal of eliminating leprosy&#46; Furthermore&#44; continuous medical follow-up must be done after a multidrug therapy in order to detect these rare variants&#46;</p></span>"
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            0 => array:3 [
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A clinical and histopathological study of histoid leprosy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Nair"
                            1 => "G&#46; Nanda Kumar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Dermatol"
                        "fecha" => "2013"
                        "volumen" => "52"
                        "paginaInicial" => "580"
                        "paginaFinal" => "586"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An update&#58; Definition&#44; pathogenesis&#44; classification&#44; diagnosis&#44; and treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46; Eichelmann"
                            1 => "S&#46; Gonz&#225;lez"
                            2 => "J&#46; Salas"
                            3 => "Ocampo J&#46; Leprosy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.adengl.2012.03.028"
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2013"
                        "volumen" => "104"
                        "paginaInicial" => "554"
                        "paginaFinal" => "563"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23870850"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Histoid leprosy&#58; the impact of the entity on the postglobal leprosy elimination era"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "V&#46; Sehgal"
                            1 => "G&#46; Srivastava"
                            2 => "N&#46; Singh"
                            3 => "P&#46; Prasad"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-4632.2009.03992.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Int J Dermatol"
                        "fecha" => "2009"
                        "volumen" => "48"
                        "numero" => "6"
                        "paginaInicial" => "603"
                        "paginaFinal" => "610"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19538369"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hansen lepromatoso histioide&#46; Caracter&#237;sticas cl&#237;nicas y epidemiol&#243;gicas en pacientes de la c&#225;tedra de dermatolog&#237;a del hospital de cl&#237;nicas&#46; Facultad de ciencias m&#233;dicas de la Universidad Nacional&#46; Asunci&#243;n&#46; Paraguay"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:5 [
                            0 => "T&#46; Moreno"
                            1 => "S&#46; Mancia"
                            2 => "B&#46; Di Martino"
                            3 => "M&#46; Rodriguez"
                            4 => "O&#46; Knopfelmacher"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Fontilles Rev Leprol&#46;"
                        "fecha" => "2013"
                        "volumen" => "29"
                        "paginaInicial" => "109"
                        "paginaFinal" => "111"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Histoid leprosy&#58; review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;K&#46; Gupta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/ijd.12799"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Dermatol"
                        "fecha" => "2015"
                        "volumen" => "54"
                        "paginaInicial" => "1283"
                        "paginaFinal" => "1288"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26094829"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lepra histioide o de Wade&#46; Presentaci&#243;n de un caso cl&#237;nico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Albrecht"
                            1 => "V&#46; Leban"
                            2 => "M&#46; Guardati"
                            3 => "J&#46; Iribas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Argent Dermatol"
                        "fecha" => "2018"
                        "volumen" => "99"
                        "paginaInicial" => "1"
                        "paginaFinal" => "10"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "De novo histoid leprosy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Kantaria"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Indian Dermatol Online J"
                        "fecha" => "2014"
                        "volumen" => "5"
                        "numero" => "4"
                        "paginaInicial" => "556"
                        "paginaFinal" => "558"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lepromatous leprosy of histoid type"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Annigeri"
                            1 => "S&#46; Metgud"
                            2 => "J&#46; Patil"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Indian J Med Microbiol"
                        "fecha" => "2007"
                        "volumen" => "25"
                        "paginaInicial" => "70"
                        "paginaFinal" => "71"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A nine-year clinicoepidemiological study of histoid Hansen in India"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46; Mendiratta"
                            1 => "A&#46; Jain"
                            2 => "R&#46; Chander"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3855/jidc.1190"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Infect Dev Ctries"
                        "fecha" => "2011"
                        "volumen" => "5"
                        "paginaInicial" => "128"
                        "paginaFinal" => "131"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21389593"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pruritic lesions during pregnancy&#58; an unusual presentation of a rare variant of multibacillary leprosy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; S&#225;nchez"
                            1 => "M&#46; Alb&#237;zuri"
                            2 => "T&#46; Gonz&#225;lez"
                            3 => "E&#46; Sendagorta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ad.2015.08.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2016"
                        "volumen" => "107"
                        "paginaInicial" => "352"
                        "paginaFinal" => "354"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26739118"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
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Case and Research Letters
Histioid Leprosy a Rare Variant: First Report in Ecuador
J.J. Dávila-Rodrígueza,
Autor para correspondencia
dr.davila.dermato@gmail.com

Corresponding author.
, C Roserob, S Telloc, S Yanchapaxia
a Departamento de Dermatología, Universidad Central del Ecuador, Quito, Ecuador
b Servicio de Dermatología, Hospital General Docente de Calderón, Quito, Ecuador
c Servicio de Patología, Hospital Axxis, Quito, Ecuador
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hiperpigmented macules and patchs on the face&#44; trunk and limbs that respect palms&#44; soles and mucosa&#44; with malaise&#44; paresthesias in upper limbs and thickening of ulnar nerves &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#44; B&#41;&#46; Bacilloscopy was positive in the ear &#43;&#43;&#44; elbow&#8239;&#43;&#8239;and knee &#43;&#46; The histopathological study shows fusiform histiocytes with a tendency to nodularity and identifies acid-alcohol resistant bacilli intracytoplasmic in macrophages&#44; compatible with histoid leprosy &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C&#44; D&#41;&#46; The patient is being treated with MDT and we added minocycline 100&#8239;mg with good clinical response by decreased size and disappearance of some nodules at the third month&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The second case is a 52 years-old male with no relevant personal history who presents asymptomatic generalized skin color nodules&#44; mainly localized in trunk and proximal limbs &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#44; B&#41;&#46; The bacilloscopy was positive in the ear &#43;&#43;&#44; elbow &#43;&#43; and knee &#43;&#46; The biopsy shows a thinned epidermis with a Grenz zone and diffuse dermal proliferation of epithelioid-vacuolated histiocytes with fusiform cells and moderate lymphocytic infiltrate&#46; Virchow historiocytes are also around the nerves &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>C&#41;&#46; Wade-Fite stain shows globus and isolated acid resistant bacilli&#44; which confirms the diagnosis of histioid leprosy &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>D&#41;&#46; The patient is being treated with WHO MDT&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">By 2003 leprosy had been eliminated from 117 countries&#44; but the disease continues to present a public health problem in 17 countries&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> It remains an enigmatic form of leprosy mostly reported from India&#44; Brasil&#44; Birmania and constitutes 1&#44;2-3&#44;5&#37; of all leprosy cases&#44; with male predominance in age range of 20-50 years&#59; however&#44; studies regarding this form of disease are very rare&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;4</span></a> HL has been reported generally to manifest in patients after long-term dapsone monotherapy&#44; irregular or inadequate therapy&#44; there are also reports of disease developing as relapse after successful treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> However&#44; de-novo cases of HL have also been encountered&#44; as our second case&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The etiopathogenesis of this entity is not clear&#44; but has been suggested to represent a hyperactive expression of multibacillary leprosy in an effort to restrict or focalize the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The interplay of genetic factors&#44; immune response and treatment received in a given patient seems to influence the manifestations of HL&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> According to Sehgal et al&#46; probably some groups of histiocytes work different from others&#44; this would explain why a combination of ordinary lepromas and histoid nodules can be found in the same patients&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The most accepted theory is that proposed by Civatte&#44; who pointed out that the histiocyte grows slowly and begins to produce large amounts of collagen under an unknown stimulus&#46; This hyperplasia produces an inflammatory process that subsequently results in the formation of a nodule&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Clinically the histoid lesions appear as smooth&#44; shiny&#44; erythematous or coppery color&#44; dome-shaped&#44; nontender soft to &#64257;rm nodules which may be super&#64257;cial or subcutaneous and plaques appearing on otherwise normal looking skin&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> The localization is usually on the posterior and lateral aspects of the arms&#44; buttocks&#44; thighs&#44; dorsum of the hands&#44; lower part of the back&#44; and over the bony prominences&#44; especially over the elbows and knees&#46; Lesions vary in size and consistency&#44; usually of 1&#46;5-3 cm&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Mendiratta et al&#46; and Nair and Nanda Kumar have reported frequencies of erythema nodosum leprosum &#40;ENL&#41; among HL cases of 40&#37;&#44; 27&#37; and 24&#37; respectively&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;9</span></a> It has been proposed that ENL probably occurs in patients during the transition to manifest HL&#44;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> as our first case&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The instant confirmation of histoid leproma is made with smears test&#44; which has a specificity of 100&#37; and a sensitivity of 50&#37;&#44; and can be obtained from nasal mucosa&#44; an ear lobe or skin lesions&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Histopathological &#64257;ndings are unique&#44; epidermis may be normal or atrophic with a Grenz zone&#46; The leproma consists of fusiform histiocytes arranged in a whorled&#44; criss-cross&#44; or storiform pattern&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Within the histiocytes&#44; plenty of acid fast bacillus can be found&#46; They are longer than the normal bacilli&#44; are uniform in length and are arranged in parallel bundles along the long axis of the spindle histiocytes with or without globus formation&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In addition the factor XIIIa positive is characteristic and the loss of S100 expression&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">It has been treated on the lines of multibacillary leprosy with the recommended WHO MDT&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Researchers have also managed initially by giving the range of motion therapy&#44; with rifampicin 600&#8239;mg&#44; o&#64258;oxacin 400&#8239;mg&#44; and minocycline 200&#8239;mg&#44; which is followed by MDT&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">To conclude&#44; it is important to recognize atypical leprosy presentations to continue the surveillance for new cases&#44; since early diagnosis and complete treatment are important to achieve our goal of eliminating leprosy&#46; Furthermore&#44; continuous medical follow-up must be done after a multidrug therapy in order to detect these rare variants&#46;</p></span>"
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          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A clinical and histopathological study of histoid leprosy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Nair"
                            1 => "G&#46; Nanda Kumar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Dermatol"
                        "fecha" => "2013"
                        "volumen" => "52"
                        "paginaInicial" => "580"
                        "paginaFinal" => "586"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An update&#58; Definition&#44; pathogenesis&#44; classification&#44; diagnosis&#44; and treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46; Eichelmann"
                            1 => "S&#46; Gonz&#225;lez"
                            2 => "J&#46; Salas"
                            3 => "Ocampo J&#46; Leprosy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.adengl.2012.03.028"
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2013"
                        "volumen" => "104"
                        "paginaInicial" => "554"
                        "paginaFinal" => "563"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23870850"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Histoid leprosy&#58; the impact of the entity on the postglobal leprosy elimination era"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "V&#46; Sehgal"
                            1 => "G&#46; Srivastava"
                            2 => "N&#46; Singh"
                            3 => "P&#46; Prasad"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-4632.2009.03992.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Int J Dermatol"
                        "fecha" => "2009"
                        "volumen" => "48"
                        "numero" => "6"
                        "paginaInicial" => "603"
                        "paginaFinal" => "610"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19538369"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hansen lepromatoso histioide&#46; Caracter&#237;sticas cl&#237;nicas y epidemiol&#243;gicas en pacientes de la c&#225;tedra de dermatolog&#237;a del hospital de cl&#237;nicas&#46; Facultad de ciencias m&#233;dicas de la Universidad Nacional&#46; Asunci&#243;n&#46; Paraguay"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:5 [
                            0 => "T&#46; Moreno"
                            1 => "S&#46; Mancia"
                            2 => "B&#46; Di Martino"
                            3 => "M&#46; Rodriguez"
                            4 => "O&#46; Knopfelmacher"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Fontilles Rev Leprol&#46;"
                        "fecha" => "2013"
                        "volumen" => "29"
                        "paginaInicial" => "109"
                        "paginaFinal" => "111"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Histoid leprosy&#58; review of the literature"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;K&#46; Gupta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/ijd.12799"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Dermatol"
                        "fecha" => "2015"
                        "volumen" => "54"
                        "paginaInicial" => "1283"
                        "paginaFinal" => "1288"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26094829"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lepra histioide o de Wade&#46; Presentaci&#243;n de un caso cl&#237;nico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Albrecht"
                            1 => "V&#46; Leban"
                            2 => "M&#46; Guardati"
                            3 => "J&#46; Iribas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Argent Dermatol"
                        "fecha" => "2018"
                        "volumen" => "99"
                        "paginaInicial" => "1"
                        "paginaFinal" => "10"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "De novo histoid leprosy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Kantaria"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Indian Dermatol Online J"
                        "fecha" => "2014"
                        "volumen" => "5"
                        "numero" => "4"
                        "paginaInicial" => "556"
                        "paginaFinal" => "558"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lepromatous leprosy of histoid type"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Annigeri"
                            1 => "S&#46; Metgud"
                            2 => "J&#46; Patil"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Indian J Med Microbiol"
                        "fecha" => "2007"
                        "volumen" => "25"
                        "paginaInicial" => "70"
                        "paginaFinal" => "71"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A nine-year clinicoepidemiological study of histoid Hansen in India"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46; Mendiratta"
                            1 => "A&#46; Jain"
                            2 => "R&#46; Chander"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3855/jidc.1190"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Infect Dev Ctries"
                        "fecha" => "2011"
                        "volumen" => "5"
                        "paginaInicial" => "128"
                        "paginaFinal" => "131"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21389593"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pruritic lesions during pregnancy&#58; an unusual presentation of a rare variant of multibacillary leprosy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; S&#225;nchez"
                            1 => "M&#46; Alb&#237;zuri"
                            2 => "T&#46; Gonz&#225;lez"
                            3 => "E&#46; Sendagorta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ad.2015.08.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2016"
                        "volumen" => "107"
                        "paginaInicial" => "352"
                        "paginaFinal" => "354"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26739118"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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