CASE REPORT article
Front. Med.
Sec. Dermatology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1596617
Rifampicin and Ofloxacin Dual Therapy as an Adjunct to Standard MB-MDT in the Management of Nodulo-Ulcerative Lepromatous Leprosy with Histoid-Like Features: A case report.
Provisionally accepted
- Datta Meghe Institute of Higher Education and Research, Wardha, India
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Leprosy, induced by Mycobacterium leprae, and in some cases, Mycobacterium lepromatosis, remains an important public health issue in endemic regions despite ongoing elimination efforts. Histoid Hansen's disease, a variant of lepromatous leprosy, is characterised by shiny, well-defined nodules and a heavy acid-fast bacillary load. We present a case of a 50-year-old male agricultural worker from rural central India presenting during a community health camp with multiple cutaneous nodules clinically suggestive of histoid leprosy. Slit-skin-smears (SSS) revealed abundant needle-shaped acid-fast bacilli, with numerous globi, whereas histopathological examination of a lesional biopsy supported the diagnosis of lepromatous leprosy (LL). This report presents a novel two-step treatment approach that is aimed at rapidly reducing infectivity using a 28-day course of rifampicin and ofloxacin (RO therapy), followed by initiation of multi-bacillary multidrug therapy (MB-MDT) to ensure sustained bacillary clearance. Repeat SSS demonstrated fragmented and granular acid-fast bacilli, indicating effective bactericidal activity. This case underscores the need for vigilant surveillance, early identification, and potential strategies to combat relapses and drug-resistant strains in the post-elimination era.
Keywords: Leprosy, Hansens disease, Lepromatous leprosy, Novel treatment, Treatment regime, Histoid hansen, Neglected Tropical Desease
Received: 19 Mar 2025; Accepted: 08 Aug 2025.
Copyright: © 2025 H, Singh, Madke and Mittal. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Varun H, Datta Meghe Institute of Higher Education and Research, Wardha, India
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