Impact of integration on the profile of newly diagnosed leprosy patients attending a referral hospital in South India.

This article compares the clinical profile of new untreated leprosy patients attending a referral hospital (The Schieffelin Institute for Health Research & Leprosy Centre, formerly known as SLR&TC, Karigiri, South India, in post-integration period (2005-2007) with that during the pre-integration period (1995-1996). A total of 529 patients--259 in pre-integration and 270 in post-integration period--were seen at this hospital. The clinical data culled from records for the earlier period were compared with data gathered prospectively for the latter period and was analyzed using SPSS software.

Nocardia farcinica pleuritis in a lepromatous patient with severe necrotizing reaction: an unusual presentation.

A young, male, lepromatous leprosy patient with a severe necrotizing erythema nodosum leprosum reaction treated with prolonged oral steroids and thalidomide developed pleuritis that was caused by a rare opportunistic pathogen, Nocardia farcinica. This organism was resistant to most antibiotics but was susceptible to amikacin and minocycline. During the course of treatment the patient developed severe gastritis which necessitated the removal of clofazimine and the inclusion of an H2 receptor antagonist.

Histological changes in the nerve, skin and nasal mucosa of patients with primary neuritic leprosy.

Primary neuritic leprosy (PNL) presents as a peripheral neuropathy with no visible skin patches and skin smears negative for acid fast bacilli. The pathogenesis of PNL is poorly understood. The aim of the study was to document the histological changes in the nerve, apparently normal skin and nasal mucosa in PNL and to study its significance to the pathogenesis of leprosy lesions.

Nasal mucosa and skin of smear-positive leprosy patients after 24 months of fixed duration MDT: histopathological and microbiological study.

The skin and nasal mucosa of 10 lepromatous leprosy patients who had completed 24 doses of fixed duration multidrug therapy (MDT) but who continued to be skin-smear positive for acid-fast bacilli (AFB) were examined histopathologically. The nasal mucosa showed granuloma fractions that exceeded those seen in the skin specimens, signifying that activity in this region subsides much more gradually than the activity in the skin. Mouse foot pad studies done using T900r mice with an inoculum from the nasal mucosa biopsy specimens of these patients did not demonstrate any growth of Mycobacterium leprae, indicating that these bacilli were not viable.

Histological studies in primary neuritic leprosy: changes in the nasal mucosa.

The nasal mucosae of 39 cases of primary neuritic leprosy (PNL) registered at Karigiri were studied histologically to determine nasal mucosal involvement in PNL and its relevance to the pathogenesis of the disease. Specific changes of leprosy were seen in 20 (51%) biopsies, ranging from macrophage granulomas with acid fast bacilli, to epithelioid granulomas and nerve inflammation. The remaining biopsies revealed chronic inflammatory changes of the mucosa or mild non-specific nerve changes.

Histological studies in primary neuritic leprosy: changes in the apparently normal skin.

The visually normal skin of 196 patients diagnosed clinically to have primary neuritic leprosy was studied histologically to determine whether there were any specific changes due to the disease in this site. Histological changes due to leprosy were seen in 32.1% of the patients, and included, indeterminate leprosy in 19.

Dapsone induced pulmonary eosinophilia without cutaneous allergic manifestations--an unusual encounter--a case report.

Dapsone is a drug of choice in the treatment of leprosy. In addition it is very useful in the treatment of many other dermatological conditions. The "dapsone-induced hypersensitivity" is not unknown.

Does clofazimine have a prophylactic role against neuritis?

A study was undertaken with the aim of testing the usefulness of clofazimine as a prophylactic agent against neuritis and nerve damage. A modified regimen, using initial high doses of clofazimine followed by regular multibacillary multidrug therapy (MB-MDT) WHO regimen, was given to a series of consecutive cases of high risk borderline leprosy patients, fulfilling defined selection criteria (n = 65). These patients were studied for the incidence of neuritis/Type I reaction, over a period of 2 years.

Clinical and histopathological activity in paucibacillary leprosy patients after fixed-duration multidrug therapy.

In 37 clinically-diagnosed borderline-tuberculoid (BT) leprosy patients skin biopsies were done prior to starting multidrug therapy (MDT) and at the end of 6 months therapy. Clinical and histopathological activity, graded as active, resolving and inactive, were studied at the end of 6 months of MDT. Of the 37 clinically-diagnosed BT patients 24 could be confirmed by histopathology as having BT leprosy, while the other 13 biopsies showed features of indeterminate (I) leprosy.

Profile of leprosy in children: past and present.

The profile of leprosy in children currently seen in a referral hospital is compared with that of children with leprosy admitted in the 1970s. Children with leprosy under the age of 15 years in 1974 and 1979 comprised one group (Group I) while those during 1989 and 1994 constituted the second group (Group II) The variables studied included age, sex, type of leprosy, deformity and contact status. Multidrug therapy (MDT) was introduced in the treatment of leprosy in 1982.

Leucocytopenia after rifampicin and ofloxacin therapy in leprosy.

New antimycobacterial agents and combined treatment regimens are being introduced for the treatment of leprosy. Ofloxacin is one such broad spectrum antimicrobial agent. In this study rifampicin plus ofloxacin were administered daily for 4 weeks (daily supervised dose).

Skin smears in leprosy: is reduction in number of sites justified?

An analysis of 377 sets of positive skin smears of leprosy patients was done to determine the minimum sites needed to detect all smear positive leprosy patients. A combination of earlobe and a selective site could pick up 95.5% of the patients.

Multibacillary nerve histology in clinically diagnosed borderline tuberculoid leprosy patients.

The classification of leprosy into multibacillary (MB) and paucibacillary (PB) patients in almost all clinics is entirely dependent on clinical examination. In a study of 21 patients clinically classified as borderline tuberculoid (BT) and, therefore, belonging to the PB group, skin smears and skin and nerve biopsies were examined. Four patients did not have any histopathological evidence of leprosy.

Climatic droplet keratopathy in leprosy.

An atypical gross form of climatic droplet keratopathy (CDK) occurring in the cornea of 24 eyes of 17 leprosy patients is described. The CDKs were situated in the lower outer quadrant of the cornea and were not associated with trauma, scars or vascularization. All patients, except one, belonged to the lepromatous group.

Intraocular pressure in leprosy patients without clinically apparent anterior segment pathology.

A widely prevalent notion is that intraocular pressures are generally lower in leprosy patients than in normal individuals. Applanation intraocular pressures were recorded in one hundred sixty-six leprosy patients who had no clinically visible anterior segment pathology and in one hundred and eleven healthy controls. Mean (SD) intraocular pressures in leprosy patients (13.

A clinico-pathological study of primary neuritic leprosy.

Normally neural involvement in leprosy is an ascending neuritis from the nerve involvement in the dermal lesions. However, in some cases neural involvement is seen in the absence of any dermal lesions. In some of these pure neuritic cases, dermal lesions appear sometime later.

Leprosy in an albino.

A case of complete albinism with Borderline Lepromatous leprosy is presented being the first report from India, of the association of these conditions.

Malignant Melanoma of Oral Cavity.

Primary malignant melanoma of oral cavity is very rare. A case of oral melanoma who died due to metastasis a year after the excision of the primary lesion is reported along with a brief review of the literature.