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LOCALIZED LEPROMATOUS LEPROSY AND ITS RESPONSE TO CHEMO‐IMMUNOTHERAPY
Author(s) -
BEENA K. R.,
ZAHEER S.A.,
GULERIA I.,
MUKHERJEE R.,
TALWAR G.P.,
MUKHERJEE A.,
RAMESH V.,
MISRA R.S.
Publication year - 1994
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/j.1365-4362.1994.tb01501.x
Subject(s) - medicine , leprosy , immunotherapy , lepromatous leprosy , mycobacterium leprae , tuberculoid leprosy , dermatology , biopsy , histopathology , immunology , pathology , immune system
Background . This is an unusual presentation of lepromatous leprosy ( ll ) in a young boy, 12 years of age. The study forms part of a large scale immunotherapeutic trial with Mycobacterium w (M.w) antileprosy vaccine. The trial is being conducted in two major hospitals in New Delhi, India. Materials and Methods . This patient presented with three lesions: one on each forearm and the third on the left leg. He was classified initially as borderline tuberculoid leprosy. Slit‐skin smears and histopathology from the lesions proved the diagnosis to be lepromatous leprosy with a bacterial index ( bi ) 6+. The initial lepromin test was negative. The patient was treated with chemo‐immunotherapy (standard multidrug therapy and immunotherapy with Mycobacterium w vaccine). Results . Investigations after 1 year (15 months) of multidrug therapy and three doses of vaccine, showed a remarkable fall in the bi from 6 to 0 in the lesions, a lepromin positivity of 5 mm, and a histological upgrading from lepromatous leprosy to borderline tuberculoid. Immunologic studies at 15 months revealed a good LTT response and high levels of cytokines, specifically IL‐2 and IFN‐γ. Conclusions . This report presents an LL patient with disease limited to a few sites. It stresses the importance of slit‐smear and biopsy in all patients of leprosy, and it highlights the upgrading observed on administration of chemo‐immunotherapy.