REPORT OF A CASE
A 28-year-old woman presented with a 3-year history of symptomless erythematous macular cutaneous lesions. These macules coalesced into large patches with geographic edges and were located mainly on the trunk and proximal surface of the extremities. Their distribution was nearly symmetrical. Skin folds were spared (Figure 1 and Figure 2). Initially, the lesions were small and almost undiscernible, but they progressively increased in size and number and became confluent. On examination, no infiltration was noted and sensation was not reduced.The patient was in otherwise general good health. Her physical examination and laboratory tests, including a complete blood cell count, serum biochemistry workup, urinalysis, and chest radiography, revealed no abnormalities.An excisional biopsy specimen was obtained from a lesion located on the trunk (Figure 3 and Figure 4). What is your diagnosis?
Lepromatous leprosy, macular stage.
H1STOPATHOLOGIC FINDINGS AND CLINICAL COURSE
Hematoxylin-eosin-stained sections showed no epidermal changes. A dermal cellular infiltrate was noted,
Miquel F, Vilata J, Gil MP, Chofre C. Asymptomatic Macular Erythematous Lesions. Arch Dermatol. 1997;133(8):1031–1032. doi:10.1001/archderm.1997.03890440113017