Wade's histoid leprosy: three clinical presentations

Wade's histoid leprosy is a rare form of multibacillary leprosy with distinctive characteristics which were first described in patients treated with a short course of sulfones. Wade's histoid leprosy may occur as a relapse, in the setting of sulfone resistance, or may present de novo. We report the clinical, histologic, immunologic, and bacteriologic features of three adult male patients with this rare variant of lepromatous leprosy as the initial presentation of the disease, observed in the Dermatology Department of Hospital Córdoba, Córdoba, Argentina between 1999 and 2003. Two of the three patients were from an endemic leprosy area. All patients presented with a number of erythematous to brownish gray, firm but elastic nodules involving mainly the extremities, which responded to treatment for multibacillary leprosy without reactional episodes.