Bahasa Indonesia
DOI:
https://doi.org/10.33820/mdvi.v50i2.406Keywords:
COVID-19, Erythema Nodosum Leprosum, Leprosy reaction, Morbus hansenAbstract
Background: Leprosy is one of the oldest and most neglected diseases in the world. During the COVID-19 pandemic, leprosy reaction triggered by COVID-19 has not been widely reported. Case: A 38-year-old woman, complained of erythema nodules in the eyelids for 1 week, increasing in size and pain accompanied by fever and nasal congestion. There is no previous history of disease or treatment. Physical examination revealed increased body temperature and anemia with bilateral madarosis. Dermatological status showed multiple erythematous nodules with regional distribution on bilateral superior palpebrae that were palpable with pain. There were multiple lesions of erosion and excoriation in the bilateral plantar pedis region. Sensory function is impaired with stocking hypoesthesia of the digits and lateral plantar pedis bilaterally. The results of the laboratory examination were SARS-CoV-2 PCR positive, ELISA anti PGL-1 IgM 8,159 u/ml, IgG 1,421 u/ml and the Bacterial Index (IB) 3+. Histopathology HE demonstrating lobular panniculitis with vasculitis and FF negative AFB. Discussion: Based on the medical history, physical examination and laboratory, the patient was diagnosed with an Erythema Nodosum Leprosum (ENL) reaction in a new case of Morbus Hansen (MH), suspected to be triggered by a COVID-19 infection. Neutrophil activity and cytokine storms due to COVID-19 are thought to trigger the ENL reaction. Conclusion: In the pandemic era, COVID-19 infection needs to be watched out for as a possible trigger for leprosy reaction.
Downloads
References
2. New Delhi: World Health Organization; Regional Office for South-East Asia. Towards zero leprosy Global Leprosy (Hansen’s disease) Strategy 2021-2030. Word Health Organization. 2021;1–30.
3. Kar H, Chauhan A. Leprosy Reactions: Pathogenesis and Clinical Features. IAL Textbook of Leprosy. 2017. 416–416 p.
4. Antunes DE, Goulart IMB, Goulart LR. Will cases of leprosy reaction increase with covid-19 infection? PLoS Negl Trop Dis. 2020;14(7):1–4.
5. Schmitz V, dos Santos JB. Covid-19, leprosy, and neutrophils. PLoS Negl Trop Dis. 2021 Jan 1;15(1):1–5.
6. Polycarpou A, Walker SL, Lockwood DNJ. A systematic review of immunological studies of erythema nodosum leprosum. Front Immunol. 2017;8(MAR).
7. Negera E, Walker SL, Girma S, Doni SN, Tsegaye D, Lambert SM, et al. Clinico-pathological features of erythema nodosum leprosum: A case-control study at ALERT hospital, Ethiopia. PLoS Negl Trop Dis. 2017;11(10):1–13.
8. Schmitz V, Tavares IF, Pignataro P, de Miranda Machado A, dos Santos Pacheco F, dos Santos JB, et al. Neutrophils in leprosy. Front Immunol. 2019;10(MAR).
9. Chatterjee D, Saikia UN, Narang T, Dogra S. The diagnostic dilemma of erythema nodosum leprosum - a clinicohistological study. Lepr Rev. 2017;88(2):217–26.
10. Garduño-Soto M, Choreño-Parra JA, Cazarin-Barrientos J. Dermatological aspects of SARS-CoV-2 infection: mechanisms and manifestations. Vol. 313, Archives of Dermatological Research. Springer Science and Business Media Deutschland GmbH; 2021. p. 611–22.
11. Monaghesh E, Hajizadeh A. The role of telehealth during COVID-19 outbreak: A systematic review based on current evidence. BMC Public Health. 2020;20(1):1–9.
