Which feature would most likely be found in a patient with lepromatous leprosy?
Correct Answer: Macrophages with a foamy appearance in the dermis
Description: The disease of leprosy is divided into two basic types: lepromatous and tuberculoid. The lepromatous form is an aggressive disease, whereas the tuberculoid form tends to be self-limiting. Individuals with lepromatous leprosy have an inflammatory skin infiltrate, which consists largely of macrophages that have a characteristic vacuolated or "foamy" appearance (caused by the accumulation of lipids within phagocytes) and intracellular acid-fast bacilli. In the lepromatous form, presence of organisms indicates impaired cellular immunity, unlike the tuberculoid type, which can effectively kill the bacteria.
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