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DIFFERENTIATION OF LEPROMATOUS FROM NEURAL LEPROSY: THE BASIS, A METHOD, AND REPORT OF FIVE CASES

DIFFERENTIATION OF LEPROMATOUS FROM NEURAL LEPROSY: THE BASIS, A METHOD, AND REPORT OF FIVE CASES Abstract The diagnosis of leprosy should in most cases permit a prognosis to be made as well. This offers three important advantages to the physician: It enables him to decide on the disposition of the case, whether to isolate or merely observe; it permits him to evaluate the effect (if any) of treatment; and it permits him (if it is favorable) to soften the blow when he informs the patient of the diagnosis. These advantages can be accomplished only by making an exact diagnosis: that is, not merely "leprosy," but "leprosy, lepromatous," or "leprosy, `neural'." Lepromatous leprosy has a bad prognosis for arrest or recovery; "neural" leprosy has a good prognosis for arrest or recovery. It is rare for the disease to undergo transition from either type to the other, and it is probably impossible for a patient to present both types simultaneously. The term "mixed leprosy" References 1. Avicenna, in Bateman, T.: A Practical Synopsis of Cutaneous Disease , ed. 1, Philadelphia, Collins & Croft, 1818. 2. Mitsuda, K., and Ogawa, M.: A Study of One Hundred and Fifty Autopsies on Cases of Leprosy , Internat. J. Leprosy 5:53 ( (Jan.) -March) 1937. 3. Sloan, N.: Tracheotomy in Leprosy , Internat. J. Leprosy , to be published. 4. Tilden, I. L.: Lepromatous Leprosy: A Reticuloendothelial Disease , Am. J. Clin. Path. 15:165 ( (May) ) 1945. 5. Hopkins, R., and Faget, G. H.: Recent Trends of Leprosy in the United States , J. A. M. A. 126:937 ( (Dec. 9) ) 1944.Crossref 6. Badger, L. F.: Significance of Positive Wassermann and Kahn Reactions in Leprosy , Pub. Health Rep. 46:957 ( (April 24) ) 1931.Crossref 7. Wade, H. W.: A Proposed Revision of the Memorial Conference Classification of Leprosy , Am. J. Trop. Med. 17:773 ( (Nov.) ) 1937. 8. "Lepromin" is meant. This was an error in terminology which was subsequently explained and corrected. 9. First International Congress on Leprosy , Internat. J. Leprosy 6:377 ( (July) -Sept.) 1938. 10. Pardo-Castello, V., and Tiant, F. R.: Leprosy , J. A. M. A. 121:1264 ( (April 17) ) 1943.Crossref 11. Tilden, I. L., and Arnold, H. L., Jr.: The Two Kinds of Leprosy: Lepromatous and Tuberculoid , Proc. Staff Meet. Clin., Honolulu 10:91 ( (Sept.) ) 1944. 12. Arnold, H. L., Jr., and Tilden, I. L.: The Classification and Nomenclature of Leprosy, with Suggestions for the Simplification of Both , Ann. Int. Med. 23:65 ( (July) ) 1945.Crossref 13. Wade, H. W., and Rodriguez, J. N.: Borderline Tuberculoid Leprosy , Internat. J. Leprosy 8:307 ( (July) -Sept.) 1940 14. The Skin Lesions of Neural Leprosy: II. Observations in Cebu , Wade Internat. J. Leprosy 5:1 ( (Jan.) -March) 1937. 15. Wade, H. W., and Fraser, N. D.: The Skin Lesions of Neural Leprosy: III. Observations in China , Internat. J. Leprosy 5:285 ( (July) -Sept.) 1937. 16. Wade, H. W.; Cochrane, R. G., and Raj, M. P.: The Skin Lesions of Neural Leprosy: IV. Observations in Madras , South India , (July) 5:437 (Oct.-Dec.) 1937. 17. Wade, H. W.; de Simon, D. S., and Fernando, A. C.: The Skin Lesions of Neural Leprosy: V. Observations in Ceylon , South India 6:199 ( (April) -June) 1938. 18. Lowe, J.: A Study of Macules in Nerve Leprosy with Particular Reference to the "Tuberculoid" Macule , Internat. J. Leprosy 5:181 ( (April) -June) 1937. 19. Ermakova, N.: The Histopathology of Simple Leprids , Internat. J. Leprosy 7:495 ( (Oct.) -Dec.) 1939. 20. Stein, A. A.: Tuberculoid Changes in Leprosy , Internat. J. Leprosy 8:41 ( (Jan.) -March) 1940. 21. Saunders, G. M., and Giffen, H. K.: The Skin Lesions of Neural Leprosy in the Virgin Islands of the United States , Internat. J. Leprosy 10:38 ( (Jan.) -March) 1942. 22. Eskey, C. R.: Personal communication to the author. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology and Syphilology American Medical Association

DIFFERENTIATION OF LEPROMATOUS FROM NEURAL LEPROSY: THE BASIS, A METHOD, AND REPORT OF FIVE CASES

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Publisher
American Medical Association
Copyright
Copyright © 1945 American Medical Association. All Rights Reserved.
ISSN
0096-6029
DOI
10.1001/archderm.1945.01510290059011
Publisher site
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Abstract

Abstract The diagnosis of leprosy should in most cases permit a prognosis to be made as well. This offers three important advantages to the physician: It enables him to decide on the disposition of the case, whether to isolate or merely observe; it permits him to evaluate the effect (if any) of treatment; and it permits him (if it is favorable) to soften the blow when he informs the patient of the diagnosis. These advantages can be accomplished only by making an exact diagnosis: that is, not merely "leprosy," but "leprosy, lepromatous," or "leprosy, `neural'." Lepromatous leprosy has a bad prognosis for arrest or recovery; "neural" leprosy has a good prognosis for arrest or recovery. It is rare for the disease to undergo transition from either type to the other, and it is probably impossible for a patient to present both types simultaneously. The term "mixed leprosy" References 1. Avicenna, in Bateman, T.: A Practical Synopsis of Cutaneous Disease , ed. 1, Philadelphia, Collins & Croft, 1818. 2. Mitsuda, K., and Ogawa, M.: A Study of One Hundred and Fifty Autopsies on Cases of Leprosy , Internat. J. Leprosy 5:53 ( (Jan.) -March) 1937. 3. Sloan, N.: Tracheotomy in Leprosy , Internat. J. Leprosy , to be published. 4. Tilden, I. L.: Lepromatous Leprosy: A Reticuloendothelial Disease , Am. J. Clin. Path. 15:165 ( (May) ) 1945. 5. Hopkins, R., and Faget, G. H.: Recent Trends of Leprosy in the United States , J. A. M. A. 126:937 ( (Dec. 9) ) 1944.Crossref 6. Badger, L. F.: Significance of Positive Wassermann and Kahn Reactions in Leprosy , Pub. Health Rep. 46:957 ( (April 24) ) 1931.Crossref 7. Wade, H. W.: A Proposed Revision of the Memorial Conference Classification of Leprosy , Am. J. Trop. Med. 17:773 ( (Nov.) ) 1937. 8. "Lepromin" is meant. This was an error in terminology which was subsequently explained and corrected. 9. First International Congress on Leprosy , Internat. J. Leprosy 6:377 ( (July) -Sept.) 1938. 10. Pardo-Castello, V., and Tiant, F. R.: Leprosy , J. A. M. A. 121:1264 ( (April 17) ) 1943.Crossref 11. Tilden, I. L., and Arnold, H. L., Jr.: The Two Kinds of Leprosy: Lepromatous and Tuberculoid , Proc. Staff Meet. Clin., Honolulu 10:91 ( (Sept.) ) 1944. 12. Arnold, H. L., Jr., and Tilden, I. L.: The Classification and Nomenclature of Leprosy, with Suggestions for the Simplification of Both , Ann. Int. Med. 23:65 ( (July) ) 1945.Crossref 13. Wade, H. W., and Rodriguez, J. N.: Borderline Tuberculoid Leprosy , Internat. J. Leprosy 8:307 ( (July) -Sept.) 1940 14. The Skin Lesions of Neural Leprosy: II. Observations in Cebu , Wade Internat. J. Leprosy 5:1 ( (Jan.) -March) 1937. 15. Wade, H. W., and Fraser, N. D.: The Skin Lesions of Neural Leprosy: III. Observations in China , Internat. J. Leprosy 5:285 ( (July) -Sept.) 1937. 16. Wade, H. W.; Cochrane, R. G., and Raj, M. P.: The Skin Lesions of Neural Leprosy: IV. Observations in Madras , South India , (July) 5:437 (Oct.-Dec.) 1937. 17. Wade, H. W.; de Simon, D. S., and Fernando, A. C.: The Skin Lesions of Neural Leprosy: V. Observations in Ceylon , South India 6:199 ( (April) -June) 1938. 18. Lowe, J.: A Study of Macules in Nerve Leprosy with Particular Reference to the "Tuberculoid" Macule , Internat. J. Leprosy 5:181 ( (April) -June) 1937. 19. Ermakova, N.: The Histopathology of Simple Leprids , Internat. J. Leprosy 7:495 ( (Oct.) -Dec.) 1939. 20. Stein, A. A.: Tuberculoid Changes in Leprosy , Internat. J. Leprosy 8:41 ( (Jan.) -March) 1940. 21. Saunders, G. M., and Giffen, H. K.: The Skin Lesions of Neural Leprosy in the Virgin Islands of the United States , Internat. J. Leprosy 10:38 ( (Jan.) -March) 1942. 22. Eskey, C. R.: Personal communication to the author.

Journal

Archives of Dermatology and Syphilology – American Medical Association

Published: Nov 1, 1945

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