Lepromin skin testing in the classification of Hansen's disease in the United States.

Hansen's disease, or leprosy, although a relatively uncommon disease in the United States, continues to be important because of its implications--physical, psychological, and social--for the patient. Prognosis and treatment of the disease are based largely on clinical classification, which ranges from the multibacillary "lepromatous" to the paucibacillary "tuberculoid" forms, depending on the patient's specific immune capabilities. Traditionally, skin testing with lepromins--suspensions of the etiologic agent of Hansen's disease, Mycobacterium leprae--have been used as adjuncts to clinical parameters for classification in endemic areas. However, these have not been systematically studied in the United States. This report describes the results obtained from skin testing 38 volunteers (22 patients and 16 uninfected persons) with standard lepromin preparations. These results support the adjunctive value of lepromins for clinically classifying Hansen's disease in our "hypoendemic" population.

Leprosy in Puerto Rico: a decade later.

A study to evaluate the changes in the incidence and prevalence of leprosy in Puerto Rico was done to include the years 1981-1989. During this period, 75 new cases were diagnosed with an average of 8.3 cases per year. The yearly incidence was 1.9 cases per million which is significantly lower to the 4.6 per million in the previous study. At the present moment 182 cases are been followed at the Tropical Diseases Clinic of the University of Puerto Rico School of Medicine with a prevalence of 5.4 per 100,000 inhabitants. It is important to notice that 16 percent of the patients at the clinic were foreigners, a significant increase from a previous study. The decrease in the incidence of leprosy may be due to advances in the treatment of the disease and the new approach to integrate the patient into the community.