Leprosy tuberculoides A30.10

The pauzibacillary tuberculoid leprosy is a relatively benign, usually non-contagious form of leprosy, which develops when the organism is well defended. In this form of leprosy, patients build up a specific immune response. A distinction is made between a minor and a major form.

Skin manifestations: A few, asymmetrically arranged, sharply demarcated, reddish or reddish-purple plaques which enlarge towards the edges and heal centrally with depigmentation and slight atrophy. Sensory disturbances: Initially hyperaesthesia, then mainly centrally loss of temperature, later touch and pain sensation. Anhidrosis. Nerve involvement: Markedly asymmetrical, often ulnar nerve. Facies antonina: facial paresis, ptosis, mimic rigidity. No involvement of internal organs.

• Minor form: Relatively stable form of tuberculoid leprosy with mildly marked skin lesions, especially near body orifices. Spontaneous regression is possible.
• Major form: Unstable form. Spontaneous recovery is possible. Frequent transition to leprosy lepromatosa or borderline leprosy of the tuberculoid type. Clinically there is a sunken pale centre; due to centrifugal growth possible formation of ring-shaped plaques, mainly localised on the buttocks, back, face, around the orifices, on the dorsal and lateral parts of the extremities.

As in lepromatous leprosy, sensory and motor deficits occur, which are manifested by pareses and secondary muscular atrophy. After healing of the skin lesions, depigmented low-grade atrophic foci can develop.

1. Al-Aboud K et al (2002) Linear cutaneous leishmaniasis occurring on a leg affected by tuberculoid leprosy. Br J Dermatol 147: 1022-1023
2. Arif T et al (2019) Leprosy in the post-elimination era: a clinico-epidemiological study from a northern Indian tertiary care hospital. Acta Dermatovenerol Alp Pannonica Adriat 28:7-10.
3. Dogra S (2002) Borderline tuberculoid leprosy and alopecia areata involving scalp. Int J Lepr Other Mycobact Dis 70: 215-216
4. Karthikeyan K et al (2001) Borderline tuberculoid leprosy with Darier's disease. Indian J Lepr 73: 169-171
5. Lawn SD et al (2003) Borderline tuberculoid leprosy: an immune reconstitution phenomenon in a human immunodeficiency virus-infected person. Clin Infect Dis 36: e5-6