Is erythema nodosum leprosum a favorable occurrence?

1- The average period of treatment until the disease could be declared arrested, in these cases in which that came about, was 57 months in the 23 patients without ENL, but 72 months in the 74 such patients with ENL. Statistically this difference in time is highly significant. There were more of these arrested patients with ENL than without it. 2- The average bacteriological index of the whole lot of ENL cases (200 patients) was higher than that of the whole group without ENL (142 patients), and the time required for the elimination of the bacilli was longer for the ENL group. 3- A mild degree of ENL retarded the arrest of the disease as much as did a severe degree of the condition. 4- The incidence of ENL increased with the duration of the disease. 5- There seems to be no great differences in occurrence of ENL among the various treatment groups (diasone, DDS, streptomycin, PAS, INH). 6- ENL is not a reaction to the drug treatment alone, as it does not occur in nonlepromatous cases under type of treatment. 7- ENL is not a favorable sign.

Hormone excretion and liver function in the gynecomastia of leprosy

1- Hormone excretion and liver function were studied in 18 lepromatous cases with gynecomastia, 20 lepromatous cases without gynecomastia, 20 tuberculoid cases, and 20 normal Bantu controls. 2- Tuberculoid cases showed minimal liver dysfunction, while marked liver dysfunction was found in lepromatous cases whether they had gynecomastia or not. 3- Hormone excretion is discussed in relation to the disease process and liver function. 4- No correlation could be found between gynecomastia and liver dysfunction or estrogen excretion, or between liver dysfunction and estrogen excretion. 5- The finding of a Klinefelter-like syndrome in four cases is mentioned.

Clinical evaluation of isonicotinic acid hydrazide as an adjuvant in the treatment of lepromatous leprosy with a note on the detrimental effect of erythema nodosum leprosum reactions

A controlled study carried out over a period of two years of the effects of sulfones alone, of isoniazid plus sulfone, of isoniazid plus dihydro streptomycin plus PAS, and a pilot study od streptohydrazid, is reported. Flaws in the method of statistical evaluation are pointed out. The significance of erythema nodosum leprosum is investigated, and the necessity of controlling the reaction is stressed.

Infections in leprosy institutions

1- Leprosy can be acquired by the adult staff in leprosy institutions. 2- A plea is made for elementary hygienic practices by the staff. 3- Infected individuals should not come in contact with children. ADDENDUM: We have recently admitted one of our European ex nurses as a patient. She started work here in 1935 when aged 22, and left to get married in 1939. Her health while she worked here was good except for attackis of tonsillitis. She knows of no accident or trauma while at work. In 1955, when aged 42, she developed tuberculoid leprosy, which responded rapidly to DDS and atabrin. She knows of no leprosy in her family, or of any contacts with leprosy since she worked here. This appears to be another instance of an adult acquiring leprosy.

Thiosemicarbazone as an additive in the treatment of leprosy

Six tuberculoid cases were treated with TB-1, and all resolved within three and aone-half years. Two illustrative cases are described. Thirty-seven lepromatous cases were treated with TB-1 for three and one-half years, with or without adjuvant sulfones. Only 4 cases became negative. Three illustrative cases that remained strongly positive are described. Thiosemicarbazone appears to be of value in tuberculoid leprosy. Its action is weak in lepromatous leprosy, and in combination with a sulfone the two drugs seem to be antagonistic.

Decolorizing of Mycobacterium leprae

1- Attention is drawn to the fact that acses are diagnosed as leprosy on the finding of acid-fast bacilli in nasal secretions or in pus. 2- Two cases are reported: -in one the acid-fast bacilli on the slide became decolorized after treatment with alcohol and it is inferred that these were diphtheroids. In the second case it was shown that bacilli which had been reported as "indistinguishable from B. leprae" were diphtheroids. 3- A plea is made for the standardization of laboratory technique.