Autoinoculation lupus vulgaris of the perineum

The case of a young heterosexual male, with a 7 year history of an asymptomatic progressive plaque over the right side of the perineum is described, which 4 years later involved the left perineum and scrotal skin, indicating autoinoculation. The diagnosis of lupus vulgaris was made by strongly positive tuberculin test, histopathology, and a favourable response to a short course of intensive antitubercular therapy.

Characterization of circulating lymphocytes by monoclonal antibodies in donovanosis

In 65 donovanosis patients, 53 ulcerogranulomatous, 10 hypertrophic, and 2 sclerotic, the hematological profile and quantitation of circulating blood lymphocyte subpopulations were studied with monoclonal antibodies and an indirect immunofluorescence technique to assess the immunological under-currents of the disease. The ulcerogranulomatous variant had increases in both total leucocyte and absolute lymphocyte counts. Total T-lymphocytes, CD4, CD8, CD22, and CD4/CD8 ratio were all significantly elevated. The hypertrophic variant, in contrast, showed a significant elevation only in the CD4/CD8 ratio.

Effect of anti-leprosy drugs on superoxide anion production by rat peritoneal macrophage with special reference to light exposed clofazimine

The present study describes the in vitro effect of anti-leprosy drugs on superoxide anion (O2-) production by rat resident peritoneal macrophages. Of the three drugs tested i.e. clofazimine, rifampicin and dapsone, the first was most effective in increasing O2- production in a dose dependent manner, while rifampicin had some stimulatory effect and dapsone exhibited minimal action. Furthermore, when clofazimine and dapsone were added together it was observed that the increase of O2- production by macrophages due to clofazimine was not significantly altered by the addition of dapsone. Moreover, it was found that killed Mycobacterium leprae could induce a lesser amount of O2- production in comparison to that of Staphylococcus aureus and the enhancement of O2- release due to clofazimine was stimulus dependent. This increase of O2- release after addition of clofazimine was inhibited by the addition of p-bromophenacyl bromide. Another interesting finding was that the enhancement of O2- production by clofazimine gradually decreased as clofazimine was exposed to light for days. On further investigation it was found that ultraviolet, NMR, infrared and mass spectra of the light unexposed and exposed drug were similar, but the diffusion current of the polarogram of light exposed drug was remarkably more than that observed in light unexposed drug, indicating, thereby, a possible increase in the electron accepting capacity of the light reacted molecule. As far as we know this is the first report describing the effect of light exposed clofazimine on the respiratory burst activity of macrophages.

Cell-mediated and humoral immunity in leprosy in children

Cell-mediated and humoral immunity were studied in 25 children between 0 and 14 years with leprosy. Cell-mediated immunity was studied in vivo by lepromin and epicutaneous sensitization with dinitrochlorobenzene (DNCB) and T-lymphocytes and their subpopulations (T4 and T8) in the peripheral blood. Humoral immunity was evaluated by B-lymphocyte count and immunoglobulins (IgG, IgM and IgA). Along with complement, component C3 was also measured in the serum. Lepromin (Mitsuda) and DNCB responses were significantly poor in mid-borderline (BB) leprosy. The hematological profile, including T-lymphocytes, their subpopulations, B-lymphocytes, serum immunoglobulins, and C3, were found to be normal in all forms of leprosy. The relatively short duration of disease and the low bacterial load may explain these findings.

Pseudoelephantiasis of the penis following donovanosis

Pseudoelephantiasis of the penis, an unusual sequel of longstanding donovanosis with otherwise characteristics clinical expression, is reported in a young man. The diagnosis was confirmed by the demonstration of Donovan bodies in Giemsa stained tissue smears and tissue sections.

Leprosy in children: correlation of clinical, histopathological, bacteriological and immunological parameters

The study of leprosy in children has indicated an incidence of 10% amongst leprosy patients attending the clinic. The duration of the disease was usually less than 2 years. The expression of leprosy in this group was either a macule and/or a plaque. Classification was, therefore, different and conforms to indeterminate (I), borderline tuberculoid (BT) and borderline (BB) leprosy. Only occasionally were other clinical variants seen. The bacteriology was largely unproductive by slit-skin smears. The lepromin (Mitsuda) responses were positive in BT and unpredictable in BB patients. Epicutaneous responses to sensitization with dinitrochlorobenzene (DNCB) paralleled responses to lepromin. Microscopic pathology was of very little help. The correlation of these parameters was only 50-60% indicating that the diagnosis of leprosy should primarily be based on clinical features.