<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2176-6223</journal-id>
<journal-title><![CDATA[Revista Pan-Amazônica de Saúde]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Pan-Amaz Saude]]></abbrev-journal-title>
<issn>2176-6223</issn>
<publisher>
<publisher-name><![CDATA[Instituto Evandro Chagas. Secretaria de Vigilância em Saúde e Ambiente. Ministério da Saúde]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2176-62232025000100040</article-id>
<article-id pub-id-type="doi">10.5123/s2176-6223202501604</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Reactional state in an atypical borderline tuberculoid leprosy: a spectrum of type 2 leprosy reaction?]]></article-title>
<article-title xml:lang="pt"><![CDATA[Estado reacional em uma hanseníase tuberculoide atípica limítrofe: um espectro de reação hansênica tipo 2?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Macêdo]]></surname>
<given-names><![CDATA[Felipe Marinho Rocha de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Farias]]></surname>
<given-names><![CDATA[Carolina Barbosa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ardito]]></surname>
<given-names><![CDATA[Maria Cecilia Leal]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferraz]]></surname>
<given-names><![CDATA[Luiza Gonçalvez de Arruda]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pereira]]></surname>
<given-names><![CDATA[Tárcio dos Santos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jardim]]></surname>
<given-names><![CDATA[Márcio Martins Lobo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Santa Casa de Misericórdia do Recife Centro de Estudos Dermatológicos do Recife ]]></institution>
<addr-line><![CDATA[Recife Pernambuco]]></addr-line>
<country>Brazil</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<volume>16</volume>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_arttext&amp;pid=S2176-62232025000100040&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_abstract&amp;pid=S2176-62232025000100040&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_pdf&amp;pid=S2176-62232025000100040&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Leprosy is a chronic granulomatous neurocutaneous disease with a wide clinical, histopathological, and immunological spectrum. Leprosy reactions can occur at any stage of the disease, even in untreated individuals, reflecting abrupt immunological shifts. This report describes a case of an otherwise healthy female patient referred to the dermatology outpatient service due to an isolated, asymptomatic, long-standing single lesion on her left thigh for five years. A diagnosis of borderline tuberculoid (BT) leprosy was made. Within 30 days, the patient complained of a sudden onset of systemic symptoms and showed multiple hemorrhagic bullae on her lower limbs, prompting suspicion of an atypical type 2 leprosy reaction. BT leprosy is typically characterized by a few scattered infiltrated plaques with asymmetrical and irregular nerve thickening. Histopathology often shows granulomas composed of epithelioid cells and an admixture of macrophages and lymphocytes. Type 2 leprosy reactions usually manifest as painful erythematous papules, plaques, and nodules. Although several type 2 reaction patterns have been described in literature, diagnosis remains challenging.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO A hanseníase é uma doença granulomatosa, crônica e neurocutânea, com largo espectro de características clínicas, histopatológicas e imunológicas. Reações hansênicas podem acontecer em qualquer estágio da doença, mesmo em indivíduos não tratados, refletindo mudanças abruptas no equilíbrio imunológico do hospedeiro. Relata-se o caso de uma paciente do sexo feminino, previamente hígida, encaminhada ao serviço de dermatologia devido queixa de lesão única, assintomática, localizada na coxa esquerda há cerca de cinco anos. O diagnóstico de hanseníase borderline-tuberculoide (BT) foi feito. Nos 30 dias seguintes, a paciente apresentou sintomas sistêmicos e múltiplas bolhas hemorrágicas nos membros inferiores, levando à suspeita imediata de reação hansênica tipo 2 atípica. A forma BT é caracterizada por poucas placas infiltradas dispersas, associadas a espessamento nervoso assimétrico e irregular. A histopatologia normalmente evidencia granuloma composto por células epitelioides e uma mistura de macrófagos e linfócitos. As reações hansênicas tipo 2 geralmente se manifestam como pápulas, placas e nódulos dolorosos. Apesar dos diversos padrões já descritos na literatura, o diagnóstico dessas reações permanece desafiador.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Leprosy]]></kwd>
<kwd lng="en"><![CDATA[Leprosy, Borderline]]></kwd>
<kwd lng="en"><![CDATA[Leprosy, Paucibacillary]]></kwd>
<kwd lng="pt"><![CDATA[Hanseníase]]></kwd>
<kwd lng="pt"><![CDATA[Hanseníase Dimorfa]]></kwd>
<kwd lng="pt"><![CDATA[Hanseníase Paucibacilar]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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