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Diagnosing Leprosy in Infants: A Histopathological Challenge using Several Staining Technique

Leprosy in infants is a rare case compared to adults. There is an excellent variety of the clinical cutaneous finding in leprosy. Leprosy diagnostic is based on the classical cardinal signs, the presence of acid-fast bacilli which is obtained by slit skin smear and skin biopsy. The gold standard to diagnose leprosy is the identification of Mycobacterium leprae (M. leprae) bacilli using Hematoxylin and Eosin (H&E) and Fite Faraco (FF) stains. Periodic acid-Schiff (PAS) and Gomori (Grocott) methenamine-silver (GMS), known to give the positive result for fungal staining, revealed the other function is becoming the alternative staining for M. leprae. Hereby, we report a case of a six-month-old male patient who presented unusual clinical findings that were never considered as leprosy initially. Histopathological examination with several stains was performed, and a diagnosis of lepromatous leprosy was obtained.