Leprosy differential diagnosis: Difference between revisions
Jump to navigation
Jump to search
Joao Silva (talk | contribs) |
Joao Silva (talk | contribs) |
||
| Line 21: | Line 21: | ||
* [[Systemic Lupus Erythematosus]] - potential fatal [[chronic]] [[autoimmune disease]], common initial and [[chronic]] complaints include [[skin rash]], [[fever]], [[malaise]], [[arthralgia|joint pains]], [[myalgia]]s and [[fatigue]. | * [[Systemic Lupus Erythematosus]] - potential fatal [[chronic]] [[autoimmune disease]], common initial and [[chronic]] complaints include [[skin rash]], [[fever]], [[malaise]], [[arthralgia|joint pains]], [[myalgia]]s and [[fatigue]. | ||
* [[Postinflammatory hypopigmented]] skin - a [[cutaneous]] condition characterized by decreased [[pigment]] in the [[skin]] following [[inflammatory reaction]] of the [[skin]]. | * [[Postinflammatory hypopigmentation|Postinflammatory hypopigmented]] skin - a [[cutaneous]] condition characterized by decreased [[pigment]] in the [[skin]] following [[inflammatory reaction]] of the [[skin]]. | ||
* [[Granuloma multiforme]] - a [[cutaneous]] condition most commonly seen in central Africa, and rarely elsewhere, characterized by [[skin lesion]]s that are located predominantly on the [[upper trunk]] and [[arms]] in sun-exposed areas.<ref name="Andrews">{{cite book |author=James, William D.; Berger, Timothy G.; et al. |title=Andrews' Diseases of the Skin: clinical Dermatology |publisher=Saunders Elsevier |location= |year=2006 |pages= |isbn=0-7216-2921-0 |oclc= |doi= |accessdate=}}</ref> | * [[Granuloma multiforme]] - a [[cutaneous]] condition most commonly seen in central Africa, and rarely elsewhere, characterized by [[skin lesion]]s that are located predominantly on the [[upper trunk]] and [[arms]] in sun-exposed areas.<ref name="Andrews">{{cite book |author=James, William D.; Berger, Timothy G.; et al. |title=Andrews' Diseases of the Skin: clinical Dermatology |publisher=Saunders Elsevier |location= |year=2006 |pages= |isbn=0-7216-2921-0 |oclc= |doi= |accessdate=}}</ref> | ||
Revision as of 20:10, 4 July 2014
|
Leprosy Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Leprosy differential diagnosis On the Web |
|
American Roentgen Ray Society Images of Leprosy differential diagnosis |
|
Risk calculators and risk factors for Leprosy differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Differential diagnosis
Leprosy may have a wide range of manifestations, each with different degrees of intensity. The diagnosis of leprosy may be hard to reach, particularly in non endemic areas, or where there is a very low prevalence of the disease. However, by acknowledging the potential diagnosis of leprosy, being familiarized and following the adequate steps for the diagnosis of this condition, will facilitate the diagnostic process. Other diseases that may mimic, or have similar features with leprosy, include:[1]
- Congenital lesions - such as nevus depigmentosus are generally present at birth and do not present with changes in sensation.
- Vitiligo - a benign lesion that presents with depigmented areas, instead of hypopigmented.
- Pityriasis alba - may be hard to distinguish from leprosy, particularly in early stages of the second, however, it is a common skin condition mostly occurring in children and usually seen as dry, fine scaled, pale patches on their faces.[2]
- Pityriasis versicolor - common skin infection caused by the yeast Malassezia furfur. This yeast is normally found on the human skin and only becomes troublesome under certain circumstances, such as a warm and humid environment, causing: generally oval or irregularly-shaped spots of 1/4 to 1 inch in diameter, often merging together to form a larger patch with a sharp border; occasional fine scaling of the skin producing a very superficial ash-like scale; and pale, dark tan, or pink in color spots, with a reddish undertone that can darken when the patient is overheated, such as in a hot shower or during/after exercise.
- Dermatophyte - parasitic fungus that infects the the skin, hair and nails due to its ability to obtain nutrients from keratinized material. The infection is usually restricted to the nonliving cornified layer of the epidermis because of their inability to penetrate viable tissue of an immunocompetent host.
- Systemic Lupus Erythematosus - potential fatal chronic autoimmune disease, common initial and chronic complaints include skin rash, fever, malaise, joint pains, myalgias and [[fatigue].
- Postinflammatory hypopigmented skin - a cutaneous condition characterized by decreased pigment in the skin following inflammatory reaction of the skin.
- Granuloma multiforme - a cutaneous condition most commonly seen in central Africa, and rarely elsewhere, characterized by skin lesions that are located predominantly on the upper trunk and arms in sun-exposed areas.[3]
- Cutaneous tuberculosis - a form of tuberculosis involving the skin. The diagnosis may be difficult, since this condition shares many similarities with other skin conditions. It may be caused by Mycobacterium tuberculosis, Mycobacterium bovis, and the BCG vaccination. Commonly the skin lesion begins as an irregular red-brown papule or nodule, with a granulomatous base. Later this lesion evolves into a painless ulcer, usually with ≤ 1cm of diameter. The most common sites of this lesion are: face and extremities.[4]
- Granuloma annulare - chronic skin disease, with unknown cause, consisting of a rash with reddish bumps arranged in a circle or ring. It most often affects children, young and older adults and it is slightly more common in females (60/40 ratio). The condition is usually seen in otherwise healthy people. Occasionally, it may be associated with diabetes or thyroid disease.
- Cutaneous leishmaniasis - a skin infection caused by a single-celled parasite that is transmitted by sand-fly bites the, constituting the most common form of leishmaniasis. The lesions typically progress from small papules to nodular plaques, and eventually lead to open sores with a raised border and central crater (ulcer), which can be covered with scales or [[crust]. These lesions are usually painless but can be painful, particularly if open sores become infected with bacteria. Satellite lesions, regional lymphadenopathy (swollen glands), and nodular lymphangitis can be noted. Commonly this condition produces less nodules than the lepromatous form of leprosy, with the skin lesions commonly resolving after a few weeks, which is uncommon in leprosy.
- Post kala-azar dermal leishmaniasis - may mimic leprosy in its presentation with hypopigmented macules, papules and nodular lesions.
- Hereditary sensory motor neuron neuropathy type III - commonly causes nerve thickening, which is present in leprosy and may therefore complicate the diagnosis.
- Amyloid -
- Keloid -
References
- ↑ Walker, Stephen L.; Lockwood, Dina N.J. (2007). "Leprosy". Clinics in Dermatology. 25 (2): 165–172. doi:10.1016/j.clindermatol.2006.05.012. ISSN 0738-081X.
- ↑ Pinto FJ, Bolognia JL (1991). "Disorders of hypopigmentation in children". Pediatr. Clin. North Am. 38 (4): 991–1017. PMID 1870914.
- ↑ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
- ↑ MacGregor RR (1995). "Cutaneous tuberculosis". Clin Dermatol. 13 (3): 245–55. PMID 8521366.