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BRIEF COMMUNICATION
Year : 2008  |  Volume : 56  |  Issue : 5  |  Page : 417-419

Histopathological study of ocular erythema nodosum leprosum and post-therapeutic scleral perforation: A case report


1 Aravind Eye Hospital and PG Institute of Ophthalmology, 1 Anna Nagar, Madurai - 625 020, India
2 St Thomas Hospital and Leprosy Centre, Chettupattu, Tamil Nadu, India

Correspondence Address:
S R Rathinam
Aravind Eye Hospital and PG Institute of Ophthalmology, 1 Anna Nagar, Madurai 625 020, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.42421

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Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae , clinically present either as tuberculoid, borderline or lepromatous type. Erythema nodosum leprosum (ENL) is an acute humoral response in the chronic course of lepromatous leprosy. Although very severe ENL reactions are known in systemic leprosy, such severity is rare in ocular tissues. A leprosy uveitis patient suffered from a severe form of post-therapeutic ENL reaction which resulted in perforation of the globe at the site of preexisting subconjunctival leproma. Painful blind eye was enucleated. Histopathological study revealed infiltration of numerous polymorphs and macrophages packed with acid-fast bacilli in the conjunctiva, cornea, ciliary body, ora serrata and sclera. A profuse influx of neutrophils on a background of macrophages packed with M. leprae confirmed the ocular ENL reaction. This case is reported to alert the ophthalmologists to a rare ocular complication of ENL.


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