ABSTRACT
A 35-year-old male with lepromatous leprosy showed significant progression of the disease on initial examination. Along with typical lepromatous skin lesions, many scar-forming lesions were present, mainly on his extremities. Some lesions showed erosive surfaces. From clinicopathological findings, these lesions were suspected to be due to the partial excretion of intradermal lepromatous granulomata by 'transepidermal elimination'. Increased local volume, which might be due mainly to rapidly growing lepromatous infiltration before chemotherapy, is suspected of triggering this phenomenon. There is no doubt that many fresh Mycobacterium leprae were included in these excretions. After the initiation of chemotherapy, no new scar-forming lesions were observed.
Subject(s)
Cicatrix/pathology , Leprosy, Lepromatous/microbiology , Leprosy, Lepromatous/pathology , Mycobacterium leprae/isolation & purification , Skin/microbiology , Adult , Biopsy, Needle , Disease Progression , Humans , Leprostatic Agents/therapeutic use , Leprosy, Lepromatous/drug therapy , Male , Skin/pathologyABSTRACT
Pulmonary lesions seen in autopsies of leprosy patients were initially thought to involve microsporidial infection. After immunohistochemical studies, it was concluded that the infectious microorganism was Cryptococcus neoformans.
Subject(s)
Cryptococcosis/diagnosis , Leprosy/complications , Lung Diseases, Fungal/diagnosis , Microsporidiosis/diagnosis , Aged , Aged, 80 and over , Animals , Cryptococcosis/complications , Cryptococcosis/microbiology , Diagnosis, Differential , Humans , Lung Diseases, Fungal/complications , Lung Diseases, Parasitic/complications , Lung Diseases, Parasitic/diagnosis , MaleABSTRACT
Lepromin reaction was studied with immunoperoxidase techniques using monoclonal antibodies. The skin reactions were induced by injecting Mitsuda antigen into healthy adults without a family history of leprosy. Both early (48 hours) and late (3 weeks and 2 months) reactions were examined. In the late reaction, focal collections of epithelioid cells had formed, and not only T- but also B-lymphocytes were observed around the granuloma. CD1a+ cells were also confirmed to have increased in the late reaction.
Subject(s)
Lepromin/pharmacology , Skin/drug effects , Antigens, CD/analysis , Female , Granuloma/chemically induced , Granuloma/pathology , Humans , Immunohistochemistry , Male , Skin/immunology , Skin/pathology , Skin Diseases/chemically induced , Skin Diseases/pathology , Time FactorsABSTRACT
The occurrence of malignant tumors in leprosy patients was studied in 252 autopsied cases. Malignant tumors were found in 33 out of 110 autopsy cases from 1962 to 1971, and in 51 out of 141 autopsy cases from 1977 to 1989 (until July). In 1974, a lepromatous case with Kaposi's sarcoma was autopsied. The incidence of malignant tumors in our 252 cases were 33.7% (85 out of 252). Carcinoma of the alimentary system was most common: stomach, liver and large intestine, in that order. There was an increased number of hepatocellular carcinoma closely related to liver cirrhosis. Carcinoma of the lung has increased remarkably in leprosy patients quite recently. Malignant lymphoma was the most common of the nonepithelial malignant tumors, and four of these cases were seen in lepromatous leprosy patients. Eight cases showed double or triple cancers; seven of these were autopsied during 1977 to 1989. Further studies should be done to ascertain which types of leprosy showed the highest incidence, and which sex showed more frequent malignant tumors.