Search

The Central American Dermatologic Society, which meets every two years in alternate capitals of Central American countries, held its Seventh Congress in Guatemala City from December 13-17, 1969. The congress was attended not only by local dermatologists but also by many of their colleagues from neighboring countries. A one-day clinical and therapeutic review, given by invited guests, preceded the congress. Leprosy, one of the serious problems of the region, was the subject of several interesting papers.

The article presents a list of words used in several papers published in the December 1974 issue of the periodical "Clinical and Experimental Immunology." Some of the words are agglutinins, allogenic cells, antibodies, cold, cross idiotypic specificity, heterophilic, malarial infection, antigens, smooth muscles, hepatitis B, hyposensitization of mast cells, lymphokines, peripheral blood, T-cells, B-Cells, hookworms, immune response, immunity, cystic fibrosis, immunofluorescence, leprosy, leucocytes migration and leukemia,

Information regarding the First International Congress in Tropical Dermatology held in Naples, Italy on June 8-13, 1964 is presented. The conference featured professor Aldo Castellani, first president of the International Society of Tropical Dermatology while professor Alfred Marchionini was elected as second president of the society and Frederick Reiss will be continuing as secretary. It featured presentations on topics including leprosy, photodermatoses, and dermatological geographic ecology.

This article presents information on the paper "Chemotherapy of Leprosy," by R.G. Cochrane that was published in a 1962 issue of the periodical "Practitioner." The newer remedies in the treatment of leprosy are reviewed. Thiambutosine (Ciba-1906; diphenlylthiourea) should be used for a period of twenty-four to thirty months. Vadrine (2- pyridyl-(4) 1,3,4,-oxydiazolone-(5) p-amino salicylate) is useful in cases intolerant of sulphones, though it should not be given for more than eighteen months. Ditopbal rubbed on in liquid form can produce dramatic improvement in the bacillary content of the skin in a relatively short time. Long-acting sulphonamides appear to be useful in patients who are intolerant to all the usual treatments, and who rapidly pass into the erythema nodosum phase.

The article discusses the problem of leprosy rehabilitation in social welfare. Before introduction of sulphone drugs, leprosy work was undertaken primarily by missionaries, by the kind-hearted but untrained volunteers. These workers undertook a tremendous task. The scientific approach to rehabilitation is of comparatively recent origin and provides the framework within which to identify the role of social welfare. Leprosy and its treatment is primarily a medical concern whereas rehabilitation is primarily a social welfare concern. In the new approach, as patients are encouraged to stay in their own society, the rehabilitation tasks have undergone some changes resulting in a greater need for professional social work. Rehabilitation should be planned for the patients who need it most. The basic criteria for rehabilitation, namely assimilation in society and economic independence, should not compromised at any cost. Rehabilitation training centres should be established with special arrangements for vocational training. In selecting the vocation, rehabilitation considerations should combine with medical considerations.

The article focuses on the book "Vascular Changes in Leprous Lesions: Consequences and Treatment," by S.N. Chatterjee. In this book Dr. Chatterjee attacks the conventional view that nerve degeneration is responsible for complications of leprosy such as hypopigmentation, anhidrosis, depilation, loss of sensation, muscle wasting and trophic ulceration. While admitting that nerve damage plays a part in some cases he maintains that not enough attention has been paid to the part played by diminished blood supply to the affected tissues.

The article focuses on the book "Leprosy for Practitioners," by S.J. Yawalker. This book of 120 pages, with 63 illustrations, is a timely and valuable addition to the literature on leprosy. Throughout the book the emphasis is on leprosy in India, but this does not detract from its value as leprosy varies but little in different races; it is a pity, however, that references to the literature are practically confined to Indian medical journals.

This article presents information about a research paper "On the Nature of the Mitsuda and the Kveim Reactions," by R. Kooij and Th. Gerritsen. Positive Mitsuda reactions were obtained with suspensions of normal liver particles in patients with tuberculoid leprosy. These suspensions gave negative results in patients with lepromatous leprosy. The Mitsuda reactions obtained with these preparations of normal tissue are similar those obtained with lepromin containing leprosy bacilli. Bacterial filtrates of lepromin and normal tissue preparations did not evoke a positive Mitsuda reaction in patients with tuberculoid leprosy. The Kveim antigen does not contain a specific substance, and the reaction produced is similar to that of a saline tissue extract. The conclusion arrived at is that the Mitsuda and Kveim reactions are of a similar nature.

The article presents information on the research paper "Leprosy: Significant Advances During the Last Decade," by R.G. Cochrane. It has been mentioned that in dealing with the diagnosis of leprosy it must be remembered that leprosy is, like syphilis, a great simulator and must always be considered whenever a person from a leprosy area is suffering from a dermatological condition which does not itch, which does not fit into one of the usual disease patterns and which has been present for more than six months. A nasal smear is almost useless in confirming a diagnosis of leprosy. Skin smears using corium tissue juice are much more diagnostic.

The article focuses on a paper on long-term treatment of leprosy with cortisone. Of the nine patients in whom it proved possible to suppress a more or less continuous lepra-reaction by means of a daily dose of 25 to 150 mg. of cortisone only 4 successfully completed the experiment, one purpose of which was to ascertain the general physiological effects of prolonged cortisone therapy. Apart from making possible, in some of the cases, treatment with D.D.S.-- administration of which in two previously recalcitrant cases it was possible to continue after the end of the cortisone the hormone itself appeared to do good.

This article presents a study related to leprosy in Jamaica by researcher E.L. De Montaigne. The study discusses the sulphones and their use in the treatment of leprosy.

This article presents information on "Classification of Leprosy," by S. N. Chatterjee published in the Indian journal "The Antiseptic." The topic discusses in some detail the difficult indeterminate and transitional cases that defy any neat system of filing.

Immunological responsiveness was studied throughout the clinical and histopathological spectrum of leprosy (Ridley-.Jopling scale) by the methods of lymphocyte transformation, leucocyte migration inhibition and delayed skin hypersensitivity, The response to Mycobactertuim leprae showed by all methods a continuous decrease from strong responses in the polar tuberculoid (TT) group to virtually negative responses in the polar lepromatous (LL) group. There was a good agreement between the iii vitro methods and the lepromin skin test, giving support to the latter as a useful tool in the evaluation of immune responsiveness to Al. leprae in leprosy patients. The immune response to BCG and PPD on the other hand, decreased only slightly towards the lepromatous pole of the spectrum, confirming the high degree of specificity of the immune defect in lepromatous leprosy. Patients grouped histologically as subpolar tuberculoid (TT/BT) reacted particularly strongly to BCG and PHD. As it is likely that the methods used mainly measured T-lymphocyte function. the clinicopathological manifestations of leprosy appear to reflect the strength of the cellular immune response against M. leprae. Thus the findings give strong support to the concept of a host-determined, immunological diseases pectrum as expressed in the Ridley-Jopling classification. [ABSTRACT FROM AUTHOR]

Purified cytoplasmic extracts were prepared from Nocardia asteroides and Nocardia brasiliensis micro-organisms. They contained protein, carbohydrate and nucleic acid material. When these extracts were utilized as skin test antigens in individuals infected with Nocardia, a delayed hypersensitivity reaction was observed. Cross reactivity occurred between the Nocardia antigens, but the inflammatory reaction was usually larger with extracts obtained from the infecting micro-organism. On the other hand, low reactivity, if any, was observed when the same antigens were assayed in patients with tuberculosis and leprosy or in healthy individuals. In addition, the cytoplasmic extract from A brasiliensis appeared useful in epidemiological studies, since skin reactivity was shown by individuals working or living in areas in which A', brasiliensis was isolated from the soil. [ABSTRACT FROM AUTHOR]

Cryoglobulins isolated from the sera of six patients with lepromatous leprosy were extensively studied by various immunochemical techniques. Immunoelectrophoresis and analytical ultracentrifugation revealed in all cases the presence of two components only, which were identified as IgG and IgM respectively. The IgG component of all six cryoprecipitates and the IgM component of five of them were polyclonal, whereas the remaining IgM component was monoclonal as it produced a narrow-banded electrophoretic spike and contained kappa light chains only. Anti-γ-globulin activity, detected in all sera and isolated cryoglobulins, was consistently found to be associated with the IgM fraction of the mixed cryoglobulins and was present at very high titres in the IgM monoclonal component. β1A serum levels were decreased in all cases. The cryoglobulins that appear to be immune complexes of the IgG/anti-IgG type may play a role in the pathogenesis of some clinical features of leprosy patients. [ABSTRACT FROM AUTHOR]

Blood lymphocytes from Malay, Indian and Chinese patients with leprosy, and from race-matched controls, were cultured in the presence of phytohaemagglutinin. Cells from Malays and Indians with lepromatous leprosy and from Malays with tuberculoid leprosy transformed as well as cells from normal controls when cultured in normal (reference) serum. Cells from lepromatous Malays and Indians transformed significantly less well than cells from normal controls when cultured in autologous serum. Normal lymphocytes transformed significantly less well when cultured in serum from lepromatous or tuberculoid Malays or from lepromatous Indians than when cultured in serum from normal controls. Lymphocytes from lepromatous Chinese transformed significantly more extensively than those from normal Chinese, whether cultured in normal (reference) or autologous serum. The ratio of transformation in autologous serum to transformation in reference serum was significantly depressed for lepromatous Chinese. Although lepromatous Chinese serum, compared with normal Chinese serum, did not depress the response of lymphocytes from one donor, there was evidence of depression when cells from another donor were used. Cells and sera from Chinese patients biopsied for suspected nasopharyngeal carcinoma behaved similarly to those from lepromatous Chinese, and not to those of normal Chinese, whether or not nasopharyngeal carcinoma was found. Lymphocytes from patients with disease classified as stable, regardless of other criteria, transformed significantly less well in either normal or autologous serum than did cells from patients with downgrading (rapidly progressive) disease. This was true of all races. In the case of Malays and Indians with stable disease the cells also transformed less well than normal cells in reference serum. [ABSTRACT FROM AUTHOR]

Ichthyosis occurs in approximately ten per cent of leprosy patients. The clinical and histological appearance of ichthyotic skin changes found in leprosy patients resembles that of ichthyosis vulgaris. Serum vitamin A and cholesterol values arc within normal limits. Other acquired forms of ichthyosis with similar morphological features are briefly reviewed. Cutaneous disturbances of vitamin A and cholesterol metabolism and the reticulo-endothelial system could possibly be responsible for these acquired ichthyotic states. [ABSTRACT FROM AUTHOR]

The diagnosis of sarcoidosis was made wrongly in the past in eases of leprosy by Boeck, Kyrle and others and that these "errors" still occur. The resemblance between sarcoidosis and tuberculoid leprosy can be so striking that it sometimes is impossible to distinguish between the two. The main cause of these errors is that sarcoidosis is not well defined. A plea is made for a descriptive definition of sarcoidosis based upon morbid histology as suggested by Scadding. The author considers sarcoidosis to be a syndrome including tuberculoid leprosy. [ABSTRACT FROM AUTHOR]

Ten Solomon Island patients with troublesome leprosy reactions were treated with clofazimine in an uncontrolled clinical trial. In every case benefit resulted to the patient in one or more of the following ways: clofazimine had the ability to suppress reactions; to replace cortico-steroid therapy; to cover the effect of increasing the dosage of dapsone; and to produce clinical improvement without serious side effects. [ABSTRACT FROM AUTHOR]

Rcent advances in leprosy have lead to great ehanges in the understanding and treatment of the disease, and it should no longer be thought of as a, social and medical disaster. [ABSTRACT FROM AUTHOR]

Sufferers of leprosy in whom the development of the disease has been arrested by the use of sulfones elect to remain in confinement when eligible to return to the general community. Stigma and the effects of prolonged tenure in the settlement are held most probably to account for this reverse isolation in a total institution. [ABSTRACT FROM AUTHOR]

This article reports the results of an immunological study of lepromatous leprosy patients, tuberculoid leprosy patients, healthy lepromin-positive patients with consanguineous leprose parents, healthy lepromin-nagative patients with consanguineous leprose parents, and healthy lepromin-positive and negative patients controls. The authors of this article concluded that there is an altered immunologic response in lepromatous patients. In this study lymphocytes were cultured, and the intradermal reaction to lepromin and the reaction to dinitrochlorobenezene were studied.

The author treated 34 patients with actinic prurigo with thalidomide. In 32 out of 34 patients a good improvement was obtained. The length of time necessary for those results was longer than that necessary for similar action in leprosy reaction. [ABSTRACT FROM AUTHOR]

The article informs about a study related to 9 months' treatment of leprosy with isoniazid, conducted by physicians F. Latapi, J.B. Rubio, O. Kodbiguez, and S.C. Estrada.