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The histology o f erythema nodosum leprosum ( E NL) shows some distinctive variations, which were considered in relation to ethnic groups in Papua New Guinea, Malaysia, Mexico and a miscellaneous group of E N L pat ients . I n highland patients of Papua New Guinea the reaction involved the connective tissues of the dermis more than the lepromatous granuloma, and the chief features were oedema and fibrinoid necrosis followed by very heavy fibrosis. Infiltration of neutrophils was a sub sidiary finding. In Malaysia, some of the features of the necrotizing form of ENL, previously described, were detectable fairly regularly even in less severe non-necrotizing lesions. In Mexican patients who developed ENL rather than the Lucio form of reaction, the ENL was of the classic type and did not differ from the ENL seen in the miscellaneous group . ENL appears to be a complex of reactions whose form may perhaps be modified by ethnic factors as well a s by the immune status within the spectrum.

The histology of erythema nodosum leprosum. Variant forms in New Guineans and other ethnic groups