Multibacillary leprosy presenting as a solitary skin lesion; report of three cases and its significance in control programs

Three patients with solitary skin lesions showing the cardinal signs of leprosy were seen and clinically classified among the paucibacillary cases. Initially, they were treated with two drugs (rifampin and dapsone) as recommended by the WHO Expert Committee. On the first visit of their follow-up, they were seen to be histopathologically either in the borderline (BB) or borderline lepromatous (BL) group, and acid-fast bacilli were demonstrated in the sections. Later they were put on three drugs (rifampin, dapsone and clofazimine) as given for multibacillary cases, and therapeutically they also behaved like bacilliferous leprosy. Such cases are rare and the reasons for the occurrence are not clear. Further studies on the subtle relationship between the local host factors and the virulence of the organisms grown from these lesions may offer an explanation. In light of these cases and previous reports of even lepromatous leprosy presenting as a single skin lesion, field workers--including both medical and paramedical workers--should carefully perform and interpret slit-skin smears from clinically diagnosed paucibacillary cases so that such unusual presentations of the disease are treated appropriately and not missed.

Multiple cutaneous nerve abscesses on a healed tuberculoid patch

A case of healed tuberculoid leprosy (TT) with multiple superficial nerve abscesses involving the whole cutaneous network on the patch is reported. To the best of our knowledge multiple cutaneous nerve abscesses involving the entire subcutaneous plexus on a TT patch is a very uncommon observation.

Colitis caused by non-steroidal anti-inflammatory drugs

Four cases of acute proctocolitis associated with non-steroidal anti-inflammatory drug therapy are presented. The drugs implicated were flufenamic acid, mefenamic acid, naproxen and ibuprofen. After resolution of symptoms and signs of proctocolitis three of the four patients were subsequently rechallenged with the implicated drug: in each there was a rapid relapse.

A Study of Behavioural Aspects of Sexually Transmitted Diseases

Some of the behaaoural aspects of 227 randomly selected male,patients attending the STD ClWc of Safung Hospitak New were The majority were below thirty years of age and poorly educated. Two thirds -of the patients were teetotalers .37.4% study group were pronuscuous and 353% of the group were repwcrs' A high of pre-marital sex was noted. 352% of the stated their spouse to be the cause of the StD. 11.9% of the study group admittc to homosexuality. Professional women (prostitutes and call girls) were the source of the majority of infections-. There was a statistically significant relationship between consumption of alcohol and promiscuity. Now of the major STDS. was significantly Mort frequently acquired from any particular source. NSU however was more frequent amongthchom . Such studies should be conducted from time to time to understand and evaluate the trend of permissiveness in the society.