Rhinophyma in a Patient with Multibacterial Indeterminate Leprosy

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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. 

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About the authors

Antonina R. Nabiyeva

Astrakhan State Medical University; Astrakhan State Technical University

Email: nabiyeva-1981@list.ru
ORCID iD: 0009-0004-9787-3736
SPIN-code: 4435-3930

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Astrakhan; Astrakhan

Anna V. Lutsenko

Astrakhan State Medical University;
Astrakhan State Technical University

Author for correspondence.
Email: ahrapova@yandex.ru
ORCID iD: 0000-0001-8423-3351
SPIN-code: 3292-9049

Cand. Sci. (Biol.), Associate Professor

Russian Federation, Astrakhan; Astrakhan

Tat'yana N. Shelepova

Astrakhan State Medical University

Email: lightmed@mail.ru
ORCID iD: 0000-0002-8172-2421
SPIN-code: 1407-1017

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Astrakhan

Lyudmila P. Voronina

Astrakhan State Medical University

Email: voroninaluda74@mail.ru
ORCID iD: 0000-0001-6766-079X
SPIN-code: 4472-1574

MD, Dr. Sci. (Med.), Professor

Russian Federation, Astrakhan

References

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  2. Belopasov VV. Typology and pathogenesis of neuropathic pain in leprosy. RMJ. Medical Review. 2018;(9):41–5. (In Russ).
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  5. Grigor’ev DV. Rosacea and rosacea-like conditions. RMJ. Dermatology. 2016;(10):627–35. (In Russ).
  6. 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).
  7. 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
  8. Wladis EJ, Adam AP. Immune signaling in rosacea. Ocul Surf. 2021;22:224–9. doi: 10.1016/j.jtos.2021.08.017
  9. Federal’nyye klinicheskiye rekomendatsii po dermatovenerologii. Dermatovenerologiya 2015: Bolezni kozhi. Infektsii, peredavayemyye polovym putem. Moscow: Delovoy Ekspress; 2016. (In Russ).

Supplementary files

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2. Fig. 1. Clinical manifestations of rhinophyma: front view (А); side view (B).

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3. Fig. 2. Biopsy material of the nose skin (hematoxylin and eosin stain): magnification × 40 (A); magnification × 100 (B).

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