摘要
麻風病由麻風桿菌(Mycobactreium leprae)引起，主要影響皮膚與周邊神經的慢性肉芽腫性感染，其主要的後遺症來自於因神經功能缺損所導致的永久性失能與殘障。在全球麻風登記病例中，東南亞的麻風人數佔全球66%，每年新增病例數約計50萬人次，而國內近年從東南亞引進大量外籍勞工，加上麻風的潛伏期長且診斷不易，所以對於境外移入個案可能導致的麻風傳播要特別留意，並應加強對麻風的警覺與診斷。本病例為34歲女性印尼雇傭，最近半年陸續於手臂、左腳和臉部出現感覺喪失的環型斑塊，病理切片下呈現非乾酪壞死性肉芽腫且有真皮神經破壞的現象，綜合臨床與病理表現，我們診斷為「中間型類結核型麻風(Borderline Tubercu-loid leprosy)」，另因患者本身為外籍勞工，所以在診斷確立後已被遣送回國，故無法繼續追蹤其後續治療情形。回顧近年來，台灣地區在麻風防治上雖已經有明顯成效，但是在引進大量東南亞外籍勞工的同時，對於麻風的防治及偵測工作則需重新省思及警覺。
並列摘要
Leprosy is caused by Mycobacterium leprae and is a chronic granulomatous infection of the skin and peripheral nerves. The main sequela of leprosy is disability due to nerve function impairment. 66% of registered patients live in South-East Asia with the total number in the region being approximately five hundred thousand. Due to the influx of foreign labor from South-East Asia in recent years, combined with a longer latency period and difficulty in diagnosis, we should keep in mind the possibility of leprosy being found in foreigners coming to our country. This patient was a 34-year-old laborer from Indonesia. During the past six months, there had been the progressive appearance of anesthetic annular plaques over the arms, left foot and face. The histopathology of a skin biopsy showed a non-Gaseous granulomatous infection with dermal nerve destruction. The diagnosis of borderline tuberculoid leprosy was made from the clinical features and histopathology of the skin biopsy. The patient was sent back to Indonesia after confirmation of a diagnosis, so we cannot give any follow-up information on her condition. Although we have attained a great improvement in the prevention of leprosy in recent years, we should reevaluate and alert those involved with leprosy prevention work at this time, especially since we have such a large number of foreign laborers coming from South-East Asia.
延伸閱讀
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