Abstract • Biopsy specimens of apparently uninvolved skin from 34 patients with lepromatous leprosy were studied histologically. Bacilli were found in 30 of 31 specimens from clinically polar or nearpolar lepromatous patients but not in the three from nonpolar patients. A predominantly perivascular distribution of infiltrate and bacilli is consistent with a hematogenous spread of infection. Subclinical, diffuse lepromatous leprosy is found in patients with nodular lesions and may precede the development of nodules. Study of apparently uninvolved skin may be helpful in classifying patients, in interpreting immunologic responses, and in elucidating the natural history of the illness. (Arch Dermatol 111:1571-1574, 1975) References 1. Ganapati R, Desikan KV, Iyer CG: Study of apparently normal skin in leprosy . Int J Lepr 40:281-290, 1972. 2. Pandya NJ, Antia NH: The value of scrotal biopsy in leprosy . Lepr Rev 45(pt (2) ):145-152, 1974. 3. Fernandez JMM: Pathology of acute reactions in leprosy . Int J Lepr 4:549-550, 1936. 4. Gougerot H, Degos R: The histobacteriology of invisible lepromata revealed by methylene blue . Int J Lepr 7:294-295, 1939. 5. Bechelli LM, de Silva E, Oliveira AB: On the histopathological findings in biopsies of apparently normal skin in cases of leprosy . Int J Lepr 13:175, 1945. 6. Browne SG: Erythema nodosum in leprosy . J Chronic Dis 16:23-30, 1963.Crossref 7. Pearson JM, Pettit JH, Siltzbach LE, et al: The Kveim test in lepromatous and tuberculoid leprosy . Int J Lepr 37:372-381, 1969. 8. Fasal P: A primer of leprosy . Cutis 7:525-534, 1971. 9. Drutz DJ, Chen TS, Lu WH: The continuous bacteremia of lepromatous leprosy . N Engl J Med 287:159-164, 1972.Crossref 10. Ridley DS, Jopling WH: Classification of leprosy according to immunity: A five-group system . Int J Lepr 34:255-273, 1966. 11. Ridley DS, Waters MF: Significance of variations within the lepromatous group . Lepr Rev 40:143-152, 1969. 12. Latapi F, Chevez Zamora A: "Spotted" leprosy of Lucio (la lepra "manchada" de Lucio) . Int J Lepr 16:421-430, 1948. 13. Moschella SL: The lepra reaction with necrotizing skin lesions . Arch Dermatol 95:565-575, 1967.Crossref 14. Rea TH, Levan NE: The concordance of tuberculin responses with the presence or absence of skin ulcerations in lepromatous leprosy . Int J Lepr 42:137-138, 1974. 15. Chase MW, Macher E: The fate of antigen in induction of delayed allergic responses , in Montagna W, Billingham RE (eds): Advances in Biology of Skin, vol 11: Immunology and the Skin . New York, Appleton-Century-Crofts, 1971, pp 63-93. 16. Waldorf DS, Sheagren JN, Trautman JR, et al: Impaired delayed hypersensitivity in patients with lepromatous leprosy . Lancet 2:773-776, 1966.Crossref 17. Turk JL, Waters MF: Cell-mediated immunity in patients with leprosy . Lancet 2:243-246, 1969.Crossref
Archives of Dermatology – American Medical Association
Published: Dec 1, 1975
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