Case Report

Evaluation 25-Hydroxyvitamin D Plasma Level on

Morbus Hansen Multibacillar Patient

Yustian Devika Rakhmawati*, Santosa Basuki*, Dyah Prabawati Retnani**

*Department of Dermatology and Venereology, Faculty of Medicine, Brawijaya University
**Department Pathology Anatomy, Faculty of Medicine, Brawijaya University
dr. Saiful Anwar Regional General Hospital, Malang, Indonesia

Abstract
Introduction :.Leprae or Morbus Hansen is caused by Mycobaterium leprae and still have a high
prevalence in Indonesia. Slit skin smear examination by calculating the bacterial index is one of the
diagnosis criteria. Vitamin D is known to have extraskeletal effects as an antimicrobe.

Case : a 19-years-old man came with chief complain of white anesthetic rash since 3 years ago. This
complaint was followed by numbness in his left leg and diminished strength on his left hand. Clinical
examination showed the presence of 3 cardinal signs, including hypopigmented anesthetic skin lesions,
thickened peripheral nerve, and positive acid-fast bacili from slit skin smear with bacterial index 5+ and
morfological index 50%. Histopathology examination on skin biopsy showed Morbus Hansen Borderline
lepromatous. Laboratory examination showed vitamin D deficiency of 11 ng/mL. Patient was treated
with MDT MB and evaluated every 4 weeks. The morphological index decline up to 30% in concordance
with the increased level of vitamine D up to 15 ng/mL.

Discussion :. Vitamin D has an activity as antimicrobe and immunomodulator in the immune system.
Morbus Hansen multibacillar with high bacterial index and morfological index needs vitamin D in tis
active form (1.25(OH)2D) and in large quantities. Improvement in morphological index associated with
increased vitamine D level.

Keywords : Morbus Hansen, Vitamin D, Antimicrobial