界限类偏结核样型麻风病1例

患者男,38岁。右手腕皮疹伴麻木1年,加重1周。皮肤科检查见右手腕屈侧黄红色环形斑块。组织病理示真皮全层可见沿血管、神经和汗腺分布的类椭圆形结核样肉芽肿,以真皮下部为著。予氨苯砜和利福平联合化疗,现随访中。     

Tuberculoid relapse in lepromatous leprosy

It is commonly accepted that the attainment of bacteriological negativity fails to restore the immune state of leprosy patients who have downgraded to lepromatous. We report six patients who had been lepromatous (LLs), and who, after many years of chemotherapy and bacteriological negativity, were found upon relapse to have upgraded to borderline-tuberculoid (BT). Five had become Mitsuda lepromin positive. The relapses could be accounted for by proven or suspected dapsone resistance. The upgrading was associated with minimal signs of reaction, which was attributed to the low level of antigen in the almost resolved lesions. The manner of development of the new high immune lesions resembled the onset of a primary infection, clinically and histologically. The development of a positive Mitsuda reaction in longstanding LL leprosy is not necessarily an indication of cure.     

Secondary Syphilis Mimicking Borderline (BL) Leprosy

A young woman with syphilids resembling borderline lepromatous (BL) leprosy is being described. This is yet another addition to its already well-documented manifestations. The high prevalence of leprosy and syphilis augments the epidemiological significance of the case.     

Pseudoepitheliomatous Epidermal Hyperplasia in Tattoos

Cutaneous reactions to tattoos are not uncommon and various histologic patterns have been reported, including lichenoid, granulomatous, eczematous, and pseudolymphomatous reactions. Such patterns may develop with highly variable delay after the tattooing procedure. We report three strikingly similar cases of a fast-occurring, tattoo-induced, cutaneous reaction strictly restricted to the red parts of the tattoos in two cases and displaying an unusual histologic pattern, i.e. pseudoepitheliomatous hyperplasia. Clinical differential diagnosis of this rare condition includes viral warts, keratoacanthoma, and verrucous carcinoma. It may be difficult to rule out the last two diagnoses and making the diagnosis usually requires full excision of the lesion, comprehensive histologic analysis, and careful follow-up.     

Tuberculoid lymph node reaction in malignant melanoma

We report on epitheloid cell reactions, forming small and large nodules within the primarily affected regional lymph nodes in malignant melanoma. The importance of such granulomas for the interpretation of lymphoscintigraphic findings is pointed out. We discuss the histogenesis and different patterns of these tumor-specific reactions. In addition, the question whether these granulomas are the result of an enhanced immunologic tumor surveillance will be under discussion.     

Lichenoid Delayed Hypersensitivity Reactions in Tattoos

Two patients with an inflammatory reaction in a red tattoo had histopathologic changes of lichen planus. The lesions demonstrated a lymphocytic bandlike infiltrate, liquefaction degeneration, acanthosis, hypergranulosis, and orthokeratosis and many hyaline bodies. Metal particles were observed in the region of the dermal-epidermal reaction. This probably is another example of the lichenoid reaction produced by delayed cellular hypersensitivity.     

Tuberculoid granuloma in a clinically normal looking skin

A case of tuberculoid leprosy showing well defined tuberculoid granuloma in the skin without any morphological changes is reported.     

Clinical Electrophysiologic Assessment of Ulnar Nerve Transposition in Tuberculoid Leprosy

Ulnar nerve transposition was accomplished in 24 tuberculoid leprotic patients, making a total of 27 operations. Results were assessed clinically and electrophysiologically, pre- and postoperatively. and compared with a control group of 30 patients. Excellent results were obtained in early cases with minimal electromyographic changes. Late cases did not improve after surgery.     

瘤型及结核样型麻风病变细胞的超微结构

麻风细胞及上皮样细胞是区分瘤型及结核样型麻风的两种病变细胞,通过电子显微镜可观察这些细胞的形态、发生及发展以得到较深入的认识.由于国内仍未见这方面的资料,故将我们的观察结果报告如下.