The first international leprosy conference, Berlin, 1897: the politics of segregation

The present paper examines the first attempts to internationalise the problem of leprosy, a subject hitherto overlooked by historians of imperialism and disease. The last decade of the nineteenth century saw many in the civilised countries of the imperialist West gripped by a paranoia about an invasion of leprosy via germ-laden immigrants and returning expatriates who had acquired the infection in leprosy endemic colonial possessions. Such alarmists clamoured for the adoption of vigorous leper segregation policies in such colonies. But the contagiousness of leprosy did not go unquestioned by other westerners. The convocation in Berlin of the first international meeting on leprosy revealed the interplay of differing and sometimes incompatible views about the containment of leprosy by segregation. The roles of officials from several countries, as well as the roles of five protagonists (Albert Ashmead, Jules Goldschmidt, Edvard Ehlers. Armauer Hansen, and Phineas Abraham) in the shaping of the Berlin Conference are here examined.     

The epidermal basement membrane zone--structure, ontogeny, and role in disease

Since many dermatologic diseases affect the epidermal basement membrane zone, there has been intense investigation into the role of epidermal basement membrane zone constituents in various skin diseases, particularly subepidermal blistering skin diseases. The epidermal basement membrane zone consists of four major structural components--the basal cell plasma membrane, the lamina lucida, the lamina densa, and the sublamina densa zone, which contains anchoring fibrils. The lamina lucida is composed of laminin, bullous pemphigoid antigen (a disease-specific glycoprotein identified by antibodies circulating in patients' sera), and other as yet poorly defined antigens identified by in vivo bound and circulating antibodies in the sera of patients with herpes gestationis, scarring pemphigoid, and others. The lamina densa consists of type IV collagen and KF-1 antigen, which is noncollagenous and is identified by a skin-specific monoclonal antibody. The sublamina densa zone consists of AF-1 and AF-2 antigens and the epidermolysis bullosa acquisita antigen(s). Knowledge of the structure and chemical composition of the basement membrane zone is critical to an understanding of some of the genetic and immunologically mediated blistering skin diseases.