{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T04:40:06Z","timestamp":1756096806147,"version":"3.44.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Leprosy, induced by <jats:italic>Mycobacterium leprae<\/jats:italic>, and in some cases, <jats:italic>Mycobacterium lepromatosis<\/jats:italic>, remains an important public health issue in endemic regions despite ongoing elimination efforts. Histoid Hansen\u2019s disease, a variant of lepromatous leprosy, is characterised by shiny, well-defined nodules and a heavy acid-fast bacillary load. We present a case of a 50-year-old male agricultural worker from rural central India presenting during a community health camp with multiple cutaneous nodules clinically suggestive of histoid leprosy. Slit-skin-smears (SSS) revealed abundant needle-shaped acid-fast bacilli, with numerous globi, whereas histopathological examination of a lesional biopsy supported the diagnosis of lepromatous leprosy (LL). This report presents a novel two-step treatment approach that is aimed at rapidly reducing infectivity using a 28-day course of rifampicin and ofloxacin (RO therapy), followed by initiation of multi-bacillary multidrug therapy (MB-MDT) to ensure sustained bacillary clearance. Repeat SSS demonstrated fragmented and granular acid-fast bacilli, indicating effective bactericidal activity. This case underscores the need for vigilant surveillance, early identification, and potential strategies to combat relapses and drug-resistant strains in the post-elimination era.<\/jats:p>","DOI":"10.3389\/fmed.2025.1596617","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T04:10:39Z","timestamp":1756095039000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Rifampicin and ofloxacin dual therapy as an adjunct to standard MB-MDT in the management of nodulo-ulcerative lepromatous leprosy with histoid-like features: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Varun","family":"H","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adarshlata","family":"Singh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhushan","family":"Madke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anurag","family":"Mittal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"ref1","article-title":"Leprosy","volume-title":"StatPearls","author":"Bhandari","year":"2025"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1080\/20477724.2022.2057722","article-title":"Global epidemiology of leprosy from 2010 to 2020: a systematic review and meta-analysis of the proportion of sex, type, grade 2 deformity 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