Leprosy mimicry of lupus vulgaris and misdiagnosis of leprosy--a case report.

Leprosy and tuberculosis (TB) both are still rampant in India. Leprosy predominantly presents through skin manifestations whereas cutaneous manifestations of TB though not so frequent but are not rare. Lupus vulgaris (LV), the commonest of all cutaneous manifestations of TB, mimics leprosy very closely and may prompt the examiner to misdiagnose leprosy, especially, by health workers (HW), in a field situation, where leprosy is diagnosed and treated on clinical basis alone as per NLEP guidelines. Because of existing stigmata, such wrong diagnosis can put the patient and the party under psychological stress and creates unnecessary complications.

Canscora decussata (Roxb.) Schult (Gentianaceae) inhibits LPS-induced expression of ICAM-1 and E-selectin on endothelial cells and carageenan-induced paw-edema in rats.

Inflammation is characterized pathologically by an increased supply of blood to the affected area, vasodilation, and infiltration of phagocytic, monocytic, and polymorphonuclear cells into the site of inflammation. The infiltration of leukocytes is in part regulated by the increased expression of cell adhesion molecules viz. ICAM-1 and E-selectin on endothelial cells. We investigated the effect of ethanolic extract prepared from plant Canscora decussata on expression of ICAM-1 and E-selectin on endothelial cells. Our results demonstrated that treatment of human endothelial cells with the extract down-regulated the LPS-induced expression of ICAM-1 and E-selectin. To study further the anti-inflammatory activity of the extract, we evaluated its effect in a rat model of carageenan-induced paw-edema. Our results showed that the extract was able to reduce the edema formation in a dose-dependent manner. These results, therefore, indicate that Canscora decussata extract could be useful towards developing effective anti-inflammatory agent(s) in the future.

IL-12 and IL-18 synergistically induce the bactericidal activity of murine peritoneal cells against M. leprae.

We examined the effect of IL-12 and IL-18 on bactericidal activities of mouse peritoneal cell (PC) against Mycobacterium leprae (M. leprae). We demonstrated that IL-12 and IL-18 synergistically induced the NO-dependent bactericidal activity of PC by stimulating Natural Killer (NK) cells and T-cells through IFN-gamma production. IL-12 and IL-18 induced host cell death through NK-cells and T-cells. Therefore. IL-12 and IL-18 play an important role on direct killing of intracellular M. leprae and on indirect killing of them through inducing host cell death.

Present leprosy situation in India and the decade long experience of this correspondent.

Leprosy, which was known to ancient India as "Kustha Roga" is thought to be its origin from India also. It is, still, a major public health problem in India affecting many people every year. India is, now, having maximum numbers of leprosy cases worldwide and accounts for 67% of total prevalence and 73% of total new case dectection. Huge numbers of new cases have been detected in recent years (Last year new cases were 782,501) because of adoption of new strategy, Modified Leprosy Elimination compaign (MLEC), and effective health education campaign. Presently, 70% of the total new caseloads of India are from five most heavily infected states. There is significant improvement in the overall situation as is evident from steady decline of prevalence rate from 38.6 cases per 10,000 population in 1985 to 5.0 per 10,000 in 1999.