[Creole dyschromia or idiopathic macular hypomelanosis of the melanodermic halfcast of Guillet-Hélénon]. / Dyschromie créole ou hypomélanose maculeuse idiopathique du métis mélanoderme de Guillet-Hélénon.

Melanodermic halfcasts may develop an original cutaneous dyschromia known as "progressive and extensive hypomelanosis" (Guillet-Helenon 1988). This disease is characterized by hypochromic and coalescent macules on the back and abdomen with possible spontaneous improvement within five years, favoured by UV exposure. The disease is not restricted to a limited geographic group: eight observations were collected in melanodermic patients leaving in temperate area. The pathogenesis of the disorder involves a variation in melanosome size and distribution with decrease in production of type IV melanosomes featuring a change of ultrastructural phenotype of melanogenesis. Since it may be misdiagnosed as fungal disease, leprosy or achromic eczema leading to useless laboratory examinations, this specific and frequent disease deserves to be known and recognized.

Leucocytic alkaline phosphatase activity in leprosy: a possible guide in the follow-up of leprosy.

In order to investigate a possible involvement of phagocytic cells in the various types of leprosy, we undertook the study of enzymatic activities in circulating leucocytes. The activity of leucocytic alkaline phosphatase was studied by histochemical techniques on blood smears in 31 patients presenting with leprosy and aged between 4 and 73, and in 11 non infected people. The 31 patients suffering from leprosy were distributed as following: 14 lepromatous leprosy of which 6 had not yet been treated and 8 were under treatment, 9 cases of tuberculoid leprosy of which 7 had been treated and 2 had not yet, 3 cases of borderline leprosy which had all been treated, and 5 patients whose form of leprosy was indeterminate (before treatment). The distribution of the different values we obtain shows a very significant difference (p less than 0.001) between patients with and without leprosy (respectively 33.8 +/- 7.3 and 109.8 +/- 12.5). Moreover, the decrease of the alkaline phosphatase activity correlated with the severity of the disease (47.2 +/- 11.4 in tuberculoid leprosy and 20.6 +/- 9.3 in lepromatous leprosy) thus suggesting that the evaluation of leucocytic alkaline phosphatase activity should be advised as a possible prognosis guide in indeterminate leprosy.

[Leprosy in young children. 2 cases at 3 years of age]. / La lèpre chez le jeune enfant. Deux observations à l'âge de 3 ans.

Two children (age 3 years) presented with leprosy in endemic area: one was type T (tuberculoid paucibacillary); the other was type BL (borderline lepromatous) considering a very fast evolution, and was treated as a multibacillary leprosy. The family of the second child reported that the onset of the disease was consecutive to an insect bite at 5 1/2 months of age. Such observations remind us that leprosy must be suspected or thought about very early since the incubation period is likely to be shorter than previously proclaimed.