Simple leg ulcers: difficult diagnosis.

Chronic leg ulcers in children in tropical developing countries are common. They are difficult to diagnose clinically and to manage. Our case illustrates that even in areas where yaws is endemic and point of care testing is available, the diagnosis remains difficult.

Analysis of the anticomplementary activity in sera of three African patients with parasitic and bacteriological infections.

The sera of three different patients from Togo, Africa were investigated with respect to their complement profile. The three patients were suffering from parasitic (Onchocerca volvulus) and bacteriological (Treponema pertenue) diseases. The total hemolytic activity (50% hemolytic complement) was markedly depressed. The analysis of the individual complement components revealed the the titers of C1, C2, C3, and C4 were lowered up to 90%, indicating an activation of the classical pathway of complement. Addition of the patients' sera to normal human serum induced a temperature-dependent consumption of C4 and C2, whereas C3 was not affected. This activity in the patients' sera eluted from a Sephadex-G-200 column with the 19 S peak and could be identified as the activated form of the first component of the complement system. The reason for the presence of activated C1, C1 in the patients' sera resides in the absence of functionally active C1 inactivator.