Cutaneous responses to antigens and irritants in patients of leprosy

Forty seven patients of various types of leprosy were skin tested with PPD, Dharmendra lepromin, DNCB, Coccidiodin, histamine and croton oil. Twenty five age matched normal controls were also included in the study. All types of leprosy patients reacted in smaller numbers and with decreased response to all antigens and irritants as compared to normal controls. Depression of response being minimum in tuberculoid and maximum in lepromatous group. None of the patients or controls reacted to coccidiodin. Details are given.

Serum lipids in leprosy

Sera of 58 patients of various types of leprosy were tested for total fat, phospholipids, cholesterol and alpha and beta lipoproteins. Total fat and both fractions of lipoproteins were found to have values comparable to normals in all types of leprosy. Serum phospholipid levels were significantly reduced in LL type of leprosy as compared to normals and TT group of patients. Similarly cholesterol levels were found to have significantly no value in LL group compared to that of the controls.

Acro-osteolysis (report of two cases and brief review of literature

Two siblings suffering from acro-osteolysis, a rare disorder, are discussed. Although three distinct types of acro-osteolysis, namely familial, idiopathic, and due to vinyl-chloride, are clearly defined, these patients did not fit into any category. They had intact nails, preserved tactile and sensory system, plantar ulceration and so sensory deficit. Nerve conduction studies showed prolongation of motor distal latencies in median, ulnar, posterior tibial and lateral popliteal nerves. Nerve biopsies from both patients showed severe loss of myelinated fibres of all sizes, but more so of small ones.

Nocardia Mycetoma At Unusual Site

A case of nocardial mycetoma is presented occurring at upper back. Clinical and laboratory studies established the diagnosis. Excellent therapeutic response was obtained with sulphadiazine alone within five months of therapy.

T and B lymphocytes and blastogenesis in leprosy

T and B cell percentages and their blastogenic response to PPD and lepromin have been studied in 107 patients of various types of leprosy. T cell counts and their blastogenic response were found to be considerably lower in all types of leprosy as compared to the normal. The counts and stimulation were the lowest for lepromatous leprosy. B cell counts were unaltered in all types of leprosy.

Histopathologic study of clinically normal appearing skin in lepromatous leprosy

Skin biopsies from clinically normal skin of the scalp, axillary and groin regions in 20 lepromatous leprosy patients revealed significant histopathological findings in upto 25 percent of the patients. The positive findings could, perhaps, be enhanced by studying larger skin materials from these body areas. Indeed, no skin area appears to be immune from invasion by Myco. leprae.

Red grain mycetoma of the scalp (Actinomadura pelletieri). A case report from India

A case of red grain mycetoma on the scalp is described. The disease, caused by Actinomadura pelletieri, is extremely rare in this part of the world, and from India this is perhaps the first case with scalp involvement. The lesion showed satisfactory response to partial excision followed by chemotherapy with streptomycin.

Cardiac dysautonomia in leprosy

Responses to various tests of cardiovascular reflexes were studied in 15 patients with leprosy. Heart rate was continuously monitored by electrocardiogram and blood pressure was recorded simultaneously. Three patients showed evidence of cardiac dysautonomia, showing involvement of both the sympathetic and parasympathetic systems. These three patients belonged to the bacilliferous group.

Study of apparently uninvolved skin in leprosy as regards bacillary population at various sites

Slit smears form 16 LL and 4 BL patients were taken from scalp, axilla, inguinal regions and apparently involved skin patch. The bacilli were found in 100% LL and 75% BL patients at all sites. Scalp showed AFB in all LL and 3 out of 4 BL cases. No lesions were seen on the scalp. Bacterial morphology showed no uniform pattern. Contrary to belief, no immune zones were found on the skin as judged by results of bacteriological examination. Our studies do not support the view that the leprosy bacillus has a predilection for sites with relatively low temperature as far as human leprosy is concerned.

Fine needle aspiration of lymph nodes in leprosy. A study of bacteriologic and morphologic indices

Lymph node aspiration was performed from the inguinal group of lymph nodes in 16 patients having lepromatous or borderline leprosy. In the same group of patients impression smears of excised lymph node and slit smears of the skin were also studied. This study made it obvious that the aspiration biopsy technic gave similar information regarding the Bacteriologic (BI) and Morphologic Indices (MI) as the impression smears of excised lymph nodes. The technic of aspiration being simple and nontraumatic is recommended for the follow-up of patients on antileprosy drugs and in reactional phases.

Evaluation of thyroid functions in leprosy. I. Thyroid function tests

Twenty six patients of different types of leprosy were studied for radio active iodine uptake (I131) and serum levels of triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH). None of the patients had clinical evidence of thyroid involvement. No significant difference was found between the values obtained in patients and normals and in different varieties of leprosy.