DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20195689

Borderline tuberculoid hansens with type 1 reaction in a HIV patient: an IRIS phenomenon over an unusual site

Chitralekhya Rao, Parthasaradhi Anchala

Abstract


Immune reconstitution inflammatory syndrome (IRIS) is an acute symptomatic expression of a latent infection during the recovery of the immune system and it occurs as a response to antiretroviral therapy. Opportunistic infections can act as a trigger for IRIS. Hansens disease is an infection caused by Mycobacterium leprae. There are very few case reports reporting the development of borderline tuberculoid hansens with type 1 reaction as IRIS. We here report a unique case of IRIS in a HIV patient who presented with borderline tuberculoid leprosy with type 1 lepra reaction presenting over unusual site following highly active antiretroviral therapy administration.


Keywords


HIV, Borderline tuberculoid hansens, Type 1 reaction, IRIS

Full Text:

PDF

References


Cusini A, Günthard HF, Weber R, Huber M, Kamarashev J, Bertisch B, et al. Lepromatous leprosy with erythema nodosum leprosum as immune reconstitution inflammatory syndrome in an HIV-1 infected patient after initiation of antiretroviral therapy. BMJ Case Rep. 2009;2009:bcr0520091904.

Mishra SK, Khadka S, Dhital S, Mahto RK, Manandhar KD. Biomarkers in immune reconstitution inflammatory syndrome (IRIS) among people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). J AIDS Clin Res. 2017;8:728.

Sharma SK, Soneja M. HIV and immune reconstitution inflammatory syndrome (IRIS). Indian J Med Res. 2011;134:866–77.

Hirsch HH, Kaufmann G, Sendi P, Battegay M. Immune reconstitution in HIV infected patients. Clin Infect Dis. 2004;38:1159-66.

Lawn SD, Wood C, Lockwood DN. Borderline tuberculoid leprosy: An immune reconstitution phenomenon in a human immunodeficiency virus-infected person. Clin Infect Dis. 2003;36:e5-6.

Pereira GA, Stefani MM, Filho JA, Souza LC, Stefani GP, Martelli CM. Human immunodeficiency virus type 1 (HIV-1) and Mycobacterium leprae co-infection: HIV-1 subtypes and clinical, immunologic and histopathologic profiles in a Brazilian cohort. Am J Trop Med Hyg. 2004;71:679-84.

Kharkar V, Bhor UH, Mahajan S, Khopkar U. Type 1 lepra reaction presenting as immune reconstitution inflammatory syndrome. Indian J Dermatol Venereol Leprol. 2007;73:253-6.

Rao GR, Amareswar A, Sandhya S. Can highly active antiretroviral therapy unmask leprosy?. A case of type 1 lepra reaction in a HIV-seropositive patient. Indian J Dermatol Venereol Leprol. 2012;78:101-3.

Mehta S, Padhiar B, Shah B. Leprosy presenting as immune reconstitution inflammatory syndrome. Indian J Sex Transm Dis. 2008;29:96-7.

Mukhopadhyay P, Pal S, Mallik S, Biswas S, Saha B. Borderline tuberculoid leprosy: A manifestation of immune reconstitution inflammatory syndrome in a human immunodeficiency virus infected person. Indian J Dermatol. 2006;51:278-80.

George A, Vidyadharan S. Hansen's disease in association with immune reconstitution inflammatory syndrome. Indian Dermatol Online J. 2016;7:29-3.