Clinico-pathological study of lymph node involvement in leprosy.

One hundred and five leprosy patients including 37 cases of LL and LI, 22 cases of BL, 3 cases of BB, 17 cases of BT, 23 cases of TT and 3 cases of indeterminate type during the period of 1980-81 have been examined clinically. All the patients of LL, LI, BL and BB types, 94% of BT, 70% of TT and 66.6% of indeterminate type have showed clinical enlargement of lymph nodes. In order of frequency the enlarged nodes are inguinal (76.2%) cervical (69.5%), axillary (69.5%), epitrochlear (64.7%) and lastly pre-auricular (9.5%). Although both regional and distant groups of lymph node enlargement have been observed in all cases of LL, LI and BL, in majority of the non-lepromatous cases there is only involvement of regional lymph nodes. Biopsies of lymph nodes are made from 51 leprosy patients, 22 from LL and LI cases, 11 from BL cases, 2 from BB cases, 8 from BT cases, 6 from TT cases and 2 from indeterminate leprosy cases. Major histopathological changes have been studied in different types of leprosy. The humoral antibody response and the cellular immune response are well reflected on the histopathological finding of the lymph nodes belonging to different immunological spectrum of leprosy patients. The examination of lymph nodes is recommended as a useful adjunct for the diagnosis and classification of leprosy.

Arteriographic pattern of plantar ulcers in lepromatous leprosy--study of 20 cases.

Sixty arteriograms were done in twenty cases of lepromatous leprosy with thirty five plantar ulcers of six months to two years duration. Tortuosity, narrowing and obliteration of vascular lumen was mostly observed. Obliteration of vascular lumen was seen in twenty five percent of cases. Arteriographic findings were directly proportional with age of patient and duration of ulcer. Hyperemia and neovascularisation were seen in active and infected ulcers. Advanced vascular changes were associated with osteolytic changes of the bone along with neurological deficit.