Histopathological features of reversal reactions in Morbus Hansen

Riski Bagus Suhendra 1, *, Diah Prabawati Retnani 2 and Anggun Putri Yuniaswan 1

1 Department of Dermatology, Venereology, and Aesthetics, Faculty of Medicine, Universitas Brawijaya, Indonesia.
2 Department of Anatomical Pathology, Faculty of Medicine, Universitas Brawijaya, Indonesia.
 
Research Article
World Journal of Advanced Research and Reviews, 2024, 23(01), 2435–2442
Article DOI: 10.30574/wjarr.2024.23.1.1194
 
Publication history: 
Received on 11 March 2024; revised on 22 April 2024; accepted on 24 April 2024
 
Abstract: 
The reversal reaction on Morbus Hansen is a type IV hypersensitivity reaction to M. leprae antigens. The clinical symptoms of a reversal reaction are that some or all of the existing lesions become more numerous and active in a short time. Hypopigmented lesions become more erythematous, erythematous lesions become increasingly erythematous, macular lesions become infiltrating, and old lesions increase in size. The histopathological feature of the reversal reaction showing dermal edema, stretching of the granulomas followed by loss of the well form granuloma arrangement, and predominance of lymphocytes are described as the hallmarks of a reversal reaction. Several additional characteristics were obtained in the form of an increase in the number of Langhans giant cells, as well as pyknosis/shrinkage of the lymphocyte nucleus. Although not a diagnostic criterion for a reversal reaction, histopathological examination of a lesion biopsy is needed to differentiate a reversal reaction in Morbus Hansen from other differential diagnoses.
 
Keywords: 
Reversal reaction; Morbus Hansen; Histopathology; Differential Diagnosis
 
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