Lepra Dimorfa Lepromatosa (Borderline Lepromatosa, BL)

a case of dimorphous lepromatous leprosy in an austrian man, who had been living in argentina for the past 40 years is reported. he presented asymptomatic, infiltrated, monomorphous plaques in his trunk and limbs, without peripheral neurologic manifestations. a skin biopsy specimen obtained from an infiltrated lesion on the back, demonstrated areas of perineural fibroblastic hyperplasia "onion-cataphylls like", granulomas contacting epidermis with violation of the grenz zone and numerous grouped acid-fast bacilli demonstrated with the ziehl-neelsen stain. the patient responded well to therapy with dapsone, rifampicine, and clofazamine, but presented a type 1 reaction (reversal reaction) which required a six-months prednisone therapy.