Localized lesions in secondary syphilis

The clinical manifestations of secondary syphilis are variable and can mimic many skin diseases, mostly being generalized and symmetrical in distribution. Localized lesions of secondary syphilis are rarely seen in dermatology clinics. We report an unusual presentation wherein a patient had localized lesions over face and soles only. There is a need for increased awareness on the part of physicians to recognize new patterns of syphilitic infection, together with a willingness to consider the diagnosis of syphilis in patients with unusual clinical features

Tuberculosis verrucosa cutis (TBVC)--foot with miliary tuberculosis.

Tuberculosis Verrucosa Cutis (TBVC) or warty tuberculosis is a variant of cutaneous tuberculosis in patients with good cell mediated immunity (CMI) to Mycobacterium Tuberculosis, while Miliary Tuberculosis is associated with very poor CMI. Two widely different clinical presentations in the same patient are very rare and being reported.

Ocorrência de dermatófitos em amostras de unhas, pés e mãos coletadas de estudantes universitários / Occurrence of dermatophyte, in nails, feet and hands of universitary students

Este trabalho teve como objetivo, avaliar a presença de dermatófitos, especificamente em unhas, pés e mãos de estudantes universitários com e sem lesões sugestivas de dermatofitose. Foram coletadas 280 amostras dessas regiões, das quais 31 (11,1 por cento) apresentaram positividade apenas pelo exame direto, e 20 (7,1 por cento) tiveram, além do exame direto positivo, crescimento de dermatófito, mediante cultivo da amostra biológica. T. rubrum foi o dermatófito isolado com maior freqüência (80 por cento), seguido por T. mentagrophytes (20 por cento). Considerando os sítios analisados neste trabalho, a ocorrência de dermatófitos foi observada em 10,4 por cento nas unhas dos pés, 5 por cento nas escamas de pés, 2,5 por cento nas unhas das mãos e apenas 0,4 por cento nas escamas das mãos.

Assessment of viability by normal mouse foot-pad and bacillary ATP bioluminescence assay in multibacillary cases treated with an MDT regimen using conventional as well as newer drugs like minocycline and ofloxacin.

The therapeutic effect of a drug regimen of conventional drugs as well as newer drugs like ofloxacin and minocycline in smear-positive multibacillary (MB) leprosy cases was assessed by mouse foot-pad and ATP bioluminiscence methods. Biopsies were taken before starting treatment and after one year of treatment. They were processed for viability assessment by normal mouse foot-pad inoculation and bacillary ATP assay techniques. The test regimen was quite effective in its anti-bacterial effect as it was found to result in loss of bacillary viability in all the cases, as assessed by both methods.

Search for newer antileprosy drugs.

In 1991 World Health Organization proclaimed the goal of global elimination of leprosy as a public health problem by year 2000 by implementing multidrug therapy (MDT). Since then the prevalence rate has declined by 85%. However, during the same period the incidence rate of leprosy has remained constant or even has been increasing. This suggests that it will take a long time for the eradication of leprosy and that without in-vitro cultivation of M. leprae, eradication of leprosy is not likely to be achieved. While in-vitro cultivation is a long-term goal, as an immediate measure, there is an urgent need for the development of newer drugs and newer multidrug therapy regimens. Using the in-vitro system for screening potential antileprosy drugs and also using the mouse foot-pad system we have evaluated several compounds in four classes of drugs--dihydrofolate reductase inhibitors, fluoroquinolones, rifampicin analogues and phenazines--and identified at least two compounds that appear to be more potent than dapsone, rifampicin and clofazimine. Newer combinations of rifampicin analogues and fluoroquinolones have also been identified that seem to be better than the combination of rifampicin and ofloxacin.

Comparative assessment of viability of M.leprae by mouse foot-pad and fluorescent staining techniques.

Morphological characteristics have been used as a parameter to assess the viability of M.leprae in leprosy patients. However, with the advent of the mouse foot-pad technique, viability of M.leprae is determined by growing the bacilli in the mouse foot-pad. In recent years, a fluorescent staining technique using fluorescent diacetate-ethidium bromide (FDA-EB) has been used to assess the viability of cultivable mycobacteria as well as M.leprae. The purpose of this study was to compare the viability of M.leprae by both mouse foot-pad and fluorescent staining techniques. M.leprae strains from both untreated and treated patients as well as mouse passaged strains of M.leprae were used for the comparison. Percentage of green-stained bacilli in the inoculum was compared with that of multiplication of M.leprae in the mouse foot-pad. It was observed that there was no correlation between the estimates of viable M.leprae by fluorescent staining and by mouse foot-pad inoculation. FDA-EB staining appears to reflect only trends as absence of green staining cells had overall general correlation with loss of infectivity to mouse foot-pad but, the converse was not found to be true.

Cultivation in vitro of acid-fast nocardioform chemoautotrophic bacteria from mouse foot-pads infected with human strains of leprosy bacillus.

Four acid-fast nocardioform bacteria could be isolated and cultivated as pure cultures in vitro from mouse foot-pads (MFP), which were infected with serially passaged strains of human leprosy bacillus; the liquid mineral medium, such as paraffin urea minimal (PUM), paraffin gelatin minimal (PGM), gelatin minimal (GM), and GM agar (GMA) slants containing only simple sources of C and N were used, just like the human and the armadillo isolates of these organisms reported earlier. Morphologically, metabolically and enzymologically, these were closely related to the previous ones and were also chemoautotrophic in nature. Serologically there appears to be a heterogenicity in these isolates, i.e., some of them showing higher affinity to nocardioforms while others showing significant binding to several mycobacteria. Normal (uninfected) mouse foot-pad harvests were not found to harbour such organisms.

Effect of diet on growth of M. leprae in mouse footpads.

Semipurified diets, with equal amounts of vitamins, minerals and fibre, but varied in protein and fat content from pork, barbel fish or soya beans were tested for their possible effect on the growth of M. leprae in mouse footpads. 105 BALB/c male weanling mice were randomly divided into five diet groups of 21 mice each and fed for six months. Differences between bacterial counts of diet groups were found. The mouse foot pad model is suitable for dietary study in leprosy.

The simultaneous inoculation of Mycobacterium leprae and M. intracellulare into nude mice: development of cutaneous leproma and accelleration of foot pad swelling.

Organisms of the non-pathogenic Mycobacterium intracellulare serotype 19 Darden enhanced the pathogenicity of M. leprae when inoculated together into the foot pads of nude mice. This supporting effect could be demonstrated by an accelleration of foot pad swelling, beginning 4 months after inoculation and by the development of cutaneous leproma on dorsal and lateral body sites within 6 months after inoculation. These leproma increased in number and size during the 9 months they were under observation and demonstrated micromorphological characteristics similar to those of human leprosy.

Levels of the third component of complement in Mycobacterium leprae infected intact and immune compromised mice.

Normal and immunosuppressed mice were infected with Mycobacterium leprae and the bacillary counts were made from the footpads at 3, 6 and 9 months post inoculation. A decrease in the serum C3 level was observed in the infected groups of animals compared to controls.

Primary dapsone resistance in leprosy.

20 carefully selected untreated patients of bacilliferous leprosy were investigated for primary dapsone resistance by foot pad inoculation. Mice were fed on 0.001 g% and 0.01 g% of dapsone during the period of study. Mice in the control group were given normal rodent feed only. Animals were sacrificed from 6 month onwards at 6 week intervals upto 9 months. In two animals the growth of M. leprae was not inhibited by 0.001 g% concentration of dapsone in diet, but was completely inhibited by 0.01 g% of dapsone.

Dapsone resistance in North India.

An attempt has been made to screen the resistant strains of M. leprae in lepromatous patients from the eight northern States of India. By using the mouse foot pad technique it was found that in a total of 69 clinically suspected patients 33 (47.8%) harboured M. leprae with some degree of dapsone resistance. A detailed epidemiological study in these parts of the country may reveal the prevalence rate.

Immunological potential of a cultivable mycobacterial strain M. habana against leprosy bacillus in mouse foot pad.

A strain of a typical mycobacteria M. habana originally afforded protection against M. tuberculosis challenge in mice, was tested for its immunological potential against leprosy bacillus in the mouse foot pad. The vaccine strain M. habana has arrested the growth of M. leprae into the mouse foot pad better than BCG (Phipps) and unvaccinated control.

Mouse foot-pad studies with M. leprae--effect of desoxy fructo serotonin (DFS) and related compounds.

Mouse foot-pad experiments were carried out to study the effects of DFS and related compounds on the multiplication of M. leprae. Of the 25 cases clinically suspected Dapsone resistance, 8 were found resistant and 14 sensitive to Dapsone by mouse foot-pad experiments. Six were resistant to DFS and 16 were sensitive. Desoxy fructo 5-hydroxy tryptophane as well as Nutrition Antileprosy (NAL) diet were also found effective in suppressing the growth of M. leprae in mouse foot-pad. Of the two liposoluble derivatives of DFS tested (DFS LS-I and DFS LS-II), DFS LS-II was found more effective in suppressing the growth of M. leprae in foot-pads of mice.

Aspectos microbiológicos dos espaços interdigitais dos pés: V. Flora microbiana aeróbica em lesöes secas e úmidas / Microbiological aspects of the toewebs: V. Aerobic microbial flora in dry and most lesions

O conhecimento da flora microbiana aeróbia das lesöes intertriginosas dos pés levou os autores a investigar eventuais diferenças entre os componentes microbianos nas lesöes secas e úmidas e também nas lesöes exulceradas com o objetivo de correlacionar a alteraçäo clínica com a composiçäo desta microflora

Aspectos microbiológicos dos espaços interdigitais dos pés: IV. Incidência de bactérias oportunistas nas lesöes intertriginosas dos pés / Microbiological aspects of toewels: IV. Occurrence of opportunistic bacteria in intertrigenous lesions of feet

Os autores, através de um estudo comparativo entre a microbiota dos espaços interdigitais dos pés sadios e lesados, se propöem a valorizar as lesöes intertriginosas dos pés como um reservatório de microorganismos transitórios, potencialmente patogênicos, considerando näo só a elevada freqüência do "pé-de-atleta" nos diferentes grupos de indivíduos como também a expressividade da populaçäo bacteriana desta dermatose