The post-lepromin scar and its significance in the control of HD.

ABSTRACT

In the past little attention has been paid to the post-lepromin scar (PLS) and its use in controlling Hansen's disease (HD), particularly in the prognosis, classification and measurement of CMI response. The immuno-information of the Mitsuda reaction is thought to be informative only in the extreme range of 10 + mm or in its absence. Previous studies have shown that the range of PLS formation increases proportionally to the degree of lepromin positivity. PLS positive HD patients have a stable form of the disease with good prognosis. Those unable to form a PLS have a marked tendency to downgrade towards the lepromatous form of HD. PLS formation appears to indicate a CMI response to M. leprae implying immunity. It is thought that there exists a correlation between the PLS and the lymphocyte transformation test (LTT), both reaching their optimum measurement three months after the M. leprae injection, either with lepromin or M. leprae suspension used for the anti-HD vaccine. It is proposed to study the use of the PLS in HD control programs on a trial basis with the objective of its general introduction as part of the management of HD control. Considerable improvements in the prognosis, classification and application of treatment can be expected from such a measure. The discovery of the armadilo as a source of M. leprae by Kirchheimer and Storrs facilitates the availability of lepromin A and its purified version, lepromin Ap. The relevant studies have shown that a 40 M/bact/ml lepromin A suspension should be used for the application of lepromin in control programs.(ABSTRACT TRUNCATED AT 250 WORDS)