Lepromatous leprosy in primigravida with early onset pre-eclampsia in third trimester: a rare case report

Abstract

Leprosy also called as Hansen's disease, one of the oldest infectious diseases in the world. It is a chronic condition that mostly affects the skin, mucous membranes, and peripheral nerves. Although leprosy is infrequently observed during pregnancy but when it occurs, can worsen and in the absence of treatment cause irreversible damage to the skin, limbs, nerves, and other organs. It is therefore necessary to have vigil eye for early diagnosis, management and treatment of leprosy during pregnancy for best maternal and fetal outcomes. We report a rarest in fact seen first time in 38 years of clinical practice, a primigravida 29-weeks pregnancy, early onset preeclampsia with lepromatous leprosy came to emergency with chief complaints of multiple erythematous papules arising all over the body mainly limbs and abdomen associated with intense pain. A diagnosis of lepromatous leprosy was made on the basis of biopsy report. Patient was treated with multidrug therapy (MDT) as per national leprosy elimination program (NLEP) successfully and delivered a healthy baby boy without any adverse maternal and perinatal outcomes. The infant growth following delivery was normal during follow up period till one year. Multidrug therapy consisting of dapsone, rifampicin and clofazimine is highly effective treatment for leprosy and considered safe for both mother and child hence treatment should be continued unchanged during pregnancy.