Subject(s)
Adrenal Cortex Hormones/adverse effects , Antitubercular Agents/therapeutic use , Axilla , Drug Therapy, Combination , Elbow , Erythema Nodosum/complications , Female , Hand , Humans , Leprostatic Agents/therapeutic use , Leprosy, Lepromatous/complications , Middle Aged , Tuberculosis, Lymph Node/complications , Tuberculosis, Osteoarticular/complicationsABSTRACT
Seventy-two cases of multibacillary leprosy were investigated for cytomorphological changes and presence of lepra bacilli in bone marrow. These patients were divided in two groups. Group A (28) comprised of new cases and group B (44) of those receiving treatment. Myeloid hyperplasia was mostly seen in patients of group B who had erythema nodosum leprosum. Megaloblastic change in erythroblasts was seen frequently in both the groups. While average number of plasma cells and macrophages was on the higher side of normal range, detection of large number of plasma cells underlined enhanced humoral response and created diagnostic problem with multiple myeloma. Morphological changes in the macrophages, their collections and epithelioid cell granulomas were observed in bone marrow. Their nature and significance is discussed.
Subject(s)
Adult , Aged , Aged, 80 and over , Bone Marrow/microbiology , Erythema Nodosum/pathology , Humans , Hyperplasia , Leprosy, Lepromatous/pathology , Macrophages/pathology , Middle Aged , Plasma Cells/pathologyABSTRACT
Two cases of lepromatous leprosy with erythema nodosum leprosum who were on high doses of clofazimine, showed discoloration of nail plate, subungual hyperkeratosis and onycholysis. These nail changes gradually disappeared when the dose of clofazimine was reduced.
Subject(s)
Clofazimine/adverse effects , Humans , Leprosy, Lepromatous/drug therapy , Nail Diseases/chemically induced , Skin Diseases/chemically inducedABSTRACT
A case of lepromatous leprosy with erythema nodosum leprosum (ENL) presenting as a myeloid leukemoid reaction is reported. Very high leucocyte count with immaturity of the cells in myeloid series was present in peripheral blood. High leucocyte alkaline phosphatase score, absence of hepatosplenomegaly and transient nature of leukemoid reaction differentiated it from chronic myeloid leukemia and acute myeloblastic leukemia. The possible mechanisms of leukemoid reaction in ENL are discussed.