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LETTER TO EDITOR
Year : 1992  |  Volume : 58  |  Issue : 1  |  Page : 49

Genital skin lesion in tuberculoid Hansen's disease


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Correspondence Address:
G Kumar Krishna


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How to cite this article:
Krishna G K. Genital skin lesion in tuberculoid Hansen's disease. Indian J Dermatol Venereol Leprol 1992;58:49

How to cite this URL:
Krishna G K. Genital skin lesion in tuberculoid Hansen's disease. Indian J Dermatol Venereol Leprol [serial online] 1992 [cited 2014 Aug 21];58:49. Available from: http://www.ijdvl.com/text.asp?1992/58/1/49/3745


To the Editor,

Fox and Knott [1] have emphasized that the genitalia are not often affected by cutaneous lesions of leprosy. Occasionally, in borderline leprosy, the lesions may be found on scrotum. [2] A child with tuberculoid Hansen's disease having lesions over the scrotum is reported here.

A boy aged 5 years presented with skin lesions over gluteal region and scrotum for 6 months. Cutaneous examination revealed two hypohidrotic,, anaesthetic patches over the gluteal region and single anaesthetic plaque over the scrotum [Figure - 1]. There was irregular localized thickening of right ulnar nerve at elbow.

Slit skin smear for AFB was negative. Biopsy of the lesions from genitalia and gluteal region confirmed the diagnosis of tuberculoid Hansen's disease.

In a study of cutaeneous lesions of leprosy on male genitalia, 13 (2.9 percent) out of 450 Hansen's disease patients had lesions over genitalia, all of them over scrotum. [3] None of BT and TT cases had lesion over genitalia. Youngest in the series was 18 years patient. Present case is of interest having scrotal skin lesion in a very young patient of TT Hansen's disease.

Involvement of the scrotal skin can be explained, as the scrotal temperature is usually several degrees below that of the abdomen (3 degree), thus confirming the general rule that leprosy bacilli favour cooler temperatures. But in literature the involvement of male genitalia is not often reported. The lesions are probably missed due either to unwillingness of patient or reluctance of the doctor to expose the patient or it may be due to inconsistent temperature prevailing in scrotal skin due to its vast radiant area, which is well vascularized and dartos muscle constantly in action trying to keep the temperature optimum for spermatogenesis rather than for Hansen's bacilli.

 
  References Top

1.Fox H, Knott J. Leprous nodules of male gentitalia. Int J Lepr 1932; 2 : 445 - 6.  Back to cited text no. 1    
2.Dharmendra, Ramu G. In : Leprosy (Dharmendra ed), Bombay : Kothari Medical Publishing House, 1978; 80.  Back to cited text no. 2    
3.Arora S K, Mukhija R D, Mohan L, Girdhar M. A study of cutaneous lesion of leprosy on male genitalia, Ind J Lepr 1989; 61 : 222-4.  Back to cited text no. 3    


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