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.

Fatal proliferative glomerulonephritis in lepromatous leprosy

A patient of lepromatous leprosy with recurrent erythema nodosum leprosum developing acute renal failure proving fatal within 8 weeks is reported. The renal lesion demonstrated acute proliferative glomerulonephritis. Its pathogenesis in relation to ENL is discussed.

Evaluation of thyroid functions in leprosy. II. Histopathology of the thyroid

Open thyroid biopsies from seven patients of bacilliferous leprosy were studied for leprous granuloma or amyloid deposition. None of the patients had clinical evidence of thyroid involvement. Histopathology did not reveal any specific abnormality.

Evaluation of thyroid functions in leprosy. III. Circulating auto-antibodies against thyroid and nuclear components

Sera from twenty six patients of various types of leprosy were tested for the detection of circulating auto-antibodies and nuclear components against thyroid using various methods. Four patients of lepromatous leprosy had higher levels of thyroid auto-antibodies by latex agglutination. Three patients showed the presence of anti-nuclear antibodies, two belonged to the TT and one to the LL group.

The role of Ga-67 citrate imaging and diagnostic ultrasound in patients with suspected abdominal abscesses

Fifty patients with suspected abdominal abscesses were examined by [67Ga[ Gallium citrate imaging and abdominal sonography. Fifteen of the patients had a proven intra-abdominal abscess; Gallium-67 images were positive in 13 (87%), while the sonogram detected the abscess in 11 (73%). Nineteen patients had true-negative radionuclide images and sonography, and one had a false-positive result by both procedures. The remaining 15 patients did not have abdominal abscesses, but did have other abnormalities (e.g., pyelonephritis, extra-abdominal sites of inflammation) which were detected by the nuclide study. Gallium-67 imaging and abdominal ultrasound have similar sensitivity for detection of abdominal abscesses. A significant advantage of Gallium imaging is its ability to detect other inflammatory foci (both within and outside the abdomen).

Significance of delayed 67Ga localization in the kidneys

One hundred and seventy-five 67Ga-citrate scans were performed to detect suspected occult inflammatory processes. None of the patients had a known malignancy. Renal activity was noted in 12 patients (6.8%) on the 48-hr image. These patients had either pyelonephritis, acute tubular necrosis, vasculitis, or a renal abscess. Since delayed 67Ga uptake in the kidneys may be the first evidence of renal disease, further investigation, including either arteriography or biopsy, is necessary. In patients with a known malignancy, tumor involvement must be considered.