Case 318 Medical history 10 year-old female patient from Vale do Mucuri, Minas Gerais, previously healthy, presents with facial and left-hand lesions. Refers that they started about 6 months ago, growing progressively, painless and non-pruritic. Denies any other complaints or comorbidities. Last attending doctor prescribed azole for 30 days, without improvement. Currently using nothing but local moisturising lotion. Image 1: Photography of facial cutaneous lesion. Image 2: Photography of cutaneous lesion on the back of left hand. Question:Considering the information provided and the photographies shown, the probable diagnosis and best conduct are, respectively: A) Cutaneous leishmaniasis; amastigote direct research. B) Sarcoidosis; skin biopsy. C) Anular granuloma; skin biopsy. D) Tuberculoid leprosy; sensitivity test. Test question (St. Joseph Hospital in Joinville/SC – 2013) About leprosy, it is correct to state that: a) Mitsuda test is used as diagnosis for leprosy. b) Indeterminate form patients may evolve to one of the other forms or heal spontaneously. c) Histopathological examination of the cutaneous lesion is essential to establish the diagnosis. d) Lepromatous form is observed in patients with deficiency on humoral immunity. e) Type 1 reactions are frequent in the polar forms of the disease (tuberculoid and lepromatous). Time is Up! Time's up
