Histoid leprosy with erythema nodosum leprosum--a case report.

Histoid leprosy is a variant of lepromatous leprosy characterized by cutaneous and/or subcutaneous nodules and plaques present over an apparently normal skin with unique histopathology and characteristic bacterial morphology. Reactions are uncommon in histoid leposy. Our patient developedtype 2 reaction after initiating MDT for leprosy.

IL-10 promoter single nucleotide polymorphisms are significantly associated with resistance to leprosy.

The minor haplotype -3575A/-2849G/-2763C in IL-10 promoter has been defined as a marker of disease resistance to leprosy and its severity in Brazilian population. Our investigation of six single-nucleotide polymorphisms (SNPs) in IL-10 promoter in 282 Indian leprosy patients and 266 healthy controls by direct PCR sequencing, however, showed that the extended haplotype: -3575T/-2849G/-2763C/-1082A/-819C/-592C was associated with resistance to leprosy per se and to the development of severe form of leprosy, using either a binomial (controls vs cases, P=0.01, OR=0.58, CI=0.37-0.89) or ordinal (controls vs paucibacillary vs multibacillary, P=0.004) model. Whereas, IL-10 haplotype -3575T/-2849G/-2763C/-1082A/-819T/-592A was associated with the risk of development of severe form of leprosy (P=0.0002) in contrast to the minor risk haplotype -3575T/-2849A/-2763C in the Brazilian population. The role of IL-10 promoter SNPs in Brazilian and Indian population strongly suggests the involvement of IL-10 locus in the outcome of leprosy.

Leprosy with neurofibromatosis--a diagnostic dilemma.

The coexistence of leprosy with neurofibromatosis is a rare finding and can pose a diagnostic dilemma. Neurofibromatosis coexisting with borderline tuberculoid leprosy has previously not been reported. We report such a case in a 13-year-old boy where biopsy of clinically uninvolved nerve revealed the presence of acid-fast bacilli. A careful diagnostic workup is needed in such cases to ensure proper treatment. Both disorders affect Schwann cells and their relationship merits further consideration.

TLR2 Arg677Trp polymorphism in leprosy: revisited.

We investigated the Toll-like receptor 2 (TLR2) Arg677Trp polymorphism, associated with lepromatous leprosy in the Korean population and shown to abrogate TLR2-mediated signalling in response to mycobacterial ligands, in 286 Indian leprosy patients and 183 ethnically matched controls. The case-control comparison also involved investigation of possible variation(s) in the promoter region of the TLR2 gene. Genotyping results after direct PCR sequencing showed that the TLR2 Arg677Trp polymorphism associated with lepromatous leprosy in the Korean population is not a true polymorphism of the TLR2 gene and has resulted from the variation present in the 93% homologous duplicated region of TLR2 exon 3 present approximately 23 kb upstream.

TLR2 Arg677rp polymorphism in leprosy: revisited

We investigated the Toll-like receptor 2 (TLR2) Arg677Trp polymorphism, associated with lepromatous leprosy in the Korean population and shown to abrogaet TLR2-mediated signalling in response to mycobacterial ligands, in 286 Indian leprosy patients and 183 ethnically matched controls. The case-control comparison also involved investigation of possible variation(s) in the promoter region of the TLR2 gene. Genotyping results after direct PCR sequencing showed that the TLR2 Arg677Trp polymorphism associated with lepromatous leprosy in the Korean population is not a true polymorphism of the TLR2 gene and has resulted from the variation present in the 93% homologous duplicated region of TLR2 exon 3 present approximately 23 kb upstream

Topical phenytoin suspension and normal saline in the treatment of leprosy trophic ulcers: a randomized, double-blind, comparative study.

OBJECTIVE: To evaluate and compare two strengths of topical phenytoin sodium suspension (2% and 4%) with normal saline in the healing of acute trophic ulcers in leprosy patients. METHODS: A prospective, parallel, double-blind, randomized study was conducted in 45 leprosy inpatients with acute trophic ulcers. Patients were randomized to receive 2%, 4% or normal saline dressing on their ulcers once daily for 4 weeks. Efficacy parameters such as a reduction in the surface area of the ulcer, bacterial culture of the ulcer swab, appearance of healthy granulation tissue, cessation of ulcer discharge and overall gradation of clinical healing and safety were assessed at weekly intervals. RESULTS: The ulcer area reduction was greater in the 2% and 4% phenytoin groups compared with the normal saline group (p<0.001). Appearance of healthy granulation tissue and cessation of ulcer discharge was also observed earlier in the two phenytoin groups. At the end of 4 weeks, 11 ulcers each had healed completely in both the 2% and 4% phenytoin groups compared with none in the control group. There were no statistical differences between the 2% and 4% phenytoin groups. No side effects were reported by any patient. CONCLUSION: Topical phenytoin appears to be an effective, safe and cheap therapeutic option for the healing of trophic ulcers in leprosy patients.

Seip-lawrence Syndrome (Three Cases in a Family).

A, rare episode of Seip-Lawrence syndrome manifesting in all three case siblings of consanpinous parents is reported. Two children we're male and one female. They exhibited low intelligence,' gaunt facies, depressed bridge of nose, large low-sct ears, thick lips and protruberant abdomen. Skin was showing hypermelanosis, hypertrichosis, absence of subcutaneous fat and acan nigricaFNx01s with' very prominent perianal rUgO6itiS In addition, the first child was short statured having hypertrophic Clitoris, hepatomcoy, left ventricular hypertro hy, hyperglycaemia and glycossuria- without ketoacidosis. The second child was, having enlargement of penis, left ventricular hypertrophy,,hepatospienomegaly and abnormal GTT. The third and the youngest child was having only cutaneous changes and no viscoromegaly or biochemical abnormality. Nou Of these patients were having gigantism and advanced bone age.

Age-at-onset of Leprosy.

In a retrospective analysis of 971 patients, the mean age at onset of the is recorded to be 24.1 years. Sex had no, influence on the age-at-onset of leprosy. However, a atatistically significant variation was noted between the type of leprosy and, the at-onset, it was the lowest (19.2 years) in indeterminate and highest (31.08 years) in neuritic leprosy. Our . ob serrations lend support to the prevailing concept that the ageat-onset of leprosy not only varies from one country to another but also indifferent parts of the same country.

Clinical and Lipid Profile Studies in Xanthelasma Palpebrarum.

The clinical cand lipid abnormalities in 45 cases of xanthelasma are reported. Their findings suggest that xanthelasma is seen in some patients as an isolated clinical symptom with normal serum lipid level% representing a local derangement of cellular lipid metabolism. Nevertheless it is noted in many patients with moderate elevation of different serum lipid fractions without any other clinical manifestations, occurring probably as a resultof benign derangement of systemic lipid metabolism. Less frequently, it is observed with significant elevation of serum lipid levels in association with certain grave abnormalities like hypertension, ischaemic heart disease,' familial hypercholesterolemia, familial xanthomatosis, diabetes etc. Thus it is inferred that the symptom xanthelasma signifies disturbed lipid metabolism of several and the, patient needs thorough investigation.

Serum Uric Acid Calcium and Phosphorus in Psoriasis.

Fifty (50) patients with different types of psoriasis and 25 controls were studied. 7 patients with psoriasis had elevated serum uric acid levels without any relation to the extent of skin involvement. AD remaining psoratics ano controls had normal levels of serum uric acid, calcium and phosphorus.

Onychomycosis in an Infant.

Distal subungual onychomycosis, caused by Trichophyton rubrum, in an otherwise healthy three months old infant, is described. This appears to be the youngest patient with this disease reported in the English literature.

Acne Vulgaris.

Acne vulgaris causes much emotional trauma, social embarrassment and cosmetic disfiguration in teenage girls and boys. The multifactorial etiology, pathogenesis and clinical features of this condition are narrated. The mechanism of comedo formation is briefly discussed. Recent concepts in the management of this chronic malady are critically reviewed.

Localized Scleroderma (case Report of 23 Cases).

Localized scleroderma is an uncommon disorder. The clinical and histological features in 23 cases of localized scleroderma are presented. A rare familial instance of encoupde sabre is described. The concurrent lesions on en coupde sabre and discoid lupus erythematous in a 16 years female is reported. It is felt important to differentiate between the facial hemiatrophy associated with en coup de, sabre and Romberg's syndrome (progressive facial hemiatrophy).

Porokeratosis of Mibelli (review of Literature and Reporte of 6 Cases).

Porokeratosis of Mibelli is a rare hereditary disorder of the skin, The salient features in 6 cases are described with a brief review of the relevant literature. Involvement of the mucous membranes was noted in 2 cases. The clinical picture was quite variable and some of the lesions resembled tinea corporis warts and neurodermatitis. Histologically cornoid lamella was the pathognomonic feature. An attempt is made to explain the relative rarity of this condtition in females on the basis of hormonal factors.