2nd Edition of Gynecology World Conference 2027

Abstract

A 31-year-old, Gravida 3 Para 2 (2002), at 37 2/7 weeks' gestation, confirmed to have multibacillary leprosy. For 13 years, she had been diagnosed with allergic dermatitis despite persistent progressive skin lesions. In the absence of peripheral neuropathy, and family history of leprosy, she was advised dermatology consultation but was lost to follow-up. During pregnancy, her cutaneous lesions progressed, and presented with prominent leonine facies and multiple erythematous subcutaneous nodules throughout the body.

She subsequently had an uncomplicated vaginal delivery. A multidisciplinary approach was undertaken. Diagnosis was confirmed by skin biopsy demonstrating acid-fast bacilli on Fite-Faraco staining.  The patient completed a 12-month course of multidrug therapy (MDT) with excellent treatment adherence, resulting in significant clinical improvement and continued disease surveillance.

Leprosy was eliminated in the Philippines in 1998, however 1,500–2,000 new cases continue to be reported annually, its variable clinical manifestations contribute to delayed diagnosis. During pregnancy, physiologic suppression of cell-mediated immunity may accelerate disease progression and vertical transmission is rare. MDT is safe during pregnancy and even lactation. The patient completed the recommended 12-month MDT treatment with good adherence and favourable maternal and neonatal outcomes.

This case highlights the importance of maintaining a high index of suspicion for leprosy and timely initiation of MDT are essential to prevent disease progression, disability, and ongoing transmission.