1/10. Common and uncommon infections of the hand.Most serious hand infections are preventable at this time if proper prophylaxis is maintained with regard to the hands and if the precursor conditions-mild inflammations and infections-are quickly and appropriately treated. In those few serious hand infections that still occur, a judicious combination of medical, surgical, and rehabilitative measures should preserve normal or at least reasonable function in practically all instances.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
2/10. Follicular mucinosis in suspected leprosy.Four cases of suspected leprosy showed, on biopsy, follicular mucinosis without any granulomatous inflammation. All the patients were adolescents (12-17 years) with a single lesion on the face. Three patients showed complete clearing after anti-leprosy treatment, and the fourth patient is currently taking anti-leprosy treatment and showed good clinical response.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
3/10. Reversal reaction to Hansen's disease.A 25-year-old man with a history of mid-borderline (BB) Hansen's disease developing a reversal reaction after starting dapsone and rifampin therapy is presented. His clinical features included erythematous, edematous plaques and peripheral neuropathy. Reversal reactions are caused immunologically by enhanced cell-mediated (Th-1) immunity to mycobacterium leprae, resulting in inflammation of infected tissues, such as skin and nerves. Acute neuritis can lead to permanent nerve damage and necessitate prompt treatment with prednisone and/or clofazamine.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
4/10. Lepromatous iridocyclitis diagnosed by anterior chamber paracentesis.A 34-year-old man with a three-month history of intraocular inflammation after ocular trauma with a fir branch, had an acute unilateral fulminant iridocyclitis. The iris had a thick, gray, cheesy membrane composed of nodular lepromata. The patient denied a history of Hansen's disease, despite the dermatologic and facial features that suggested the diagnosis. anterior chamber paracentesis and scleral nodule biopsy demonstrated Mycobacterium lepra. The iridocyclitis resolved after treatment with dapsone, corticosteroids, and rifampin.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
5/10. Electrophysiologic and histologic studies in leprosy and some acrodystrophic neuropathies.in vitro electrophysiologic and light microscopic studies were carried out on the sural nerve in six patients with non-leprous neuropathy with plantar ulceration and in six patients with various types of leprous neuropathy. In the non-leprous group (with congenital and acquired neuropathy) the abnormalities in the compound action potentials of the myelinated (large and small) fibers were usually more striking than those in the unmyelinated fibers potentials. In the leprous neuropathies, on the other hand, the three major fiber groups tended to be involved indiscriminately, the unmyelinated fiber potential being as liable to abnormality as the myelinated fiber potentials. Histologically the nerve fiber damage in the congenital neuropathies appeared to be moderate to gross involvement of the myelinated fibers without the prominent demyelination and degeneration/regeneration seen in leprosy and the other acquired neuropathies. Leprous neuropathy showed, besides fiber abnormalities, the simultaneous deleterious effects of inflammation and fibrosis. It is a matter for speculation whether disturbed conduction in the large myelinated touch-pressure mediating fibers contributes significantly to impaired pain perception (mediated by small fibers) and plantar ulceration in leprosy and other acrodystrophic neuropathies.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
6/10. Untreated Hansen's disease of the eye: a clinicopathological report.A Maltese immigrant presented with intermittent bilateral anterior uveitis for which no cause could be found. The inflammation did not respond to topical treatment and ultimately the left eye developed a hypopyon and was enucleated. Histological examination revealed granulomatous inflammation and large numbers of mycobacterium leprae throughout the anterior segment. Occasional foci of inflammation containing mycobacterium leprae were found in the vitreous extending to the retina at the posterior pole. These findings in the posterior segment have rarely been reported. eye infection in Hansen's disease is frequent and delays in diagnosis are common.- - - - - - - - - - ranking = 3keywords = inflammation (Clic here for more details about this article) |
7/10. Early leprosy with perineural proliferation.A 62-year-old woman, who lived in an area of the united states nonendemic for leprosy, was seen for an enlarging anesthetic lesion that involved the entire left breast. Microscopic examination of skin biopsy specimens taken from the edge of the lesion disclosed chronic perineural inflammation and neural proliferation, with an acid-fast bacillus demonstrable in one nerve. Granulomas, giant cells, epithelioid cells, nerve abscesses, or other characteristics of tuberculoid leprosy were not seen. This woman had a skin lesion of leprosy in an atypical site. It appeared to be indeterminate on pathologic examination and was accompanied by an unusual degree of neural proliferation.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
8/10. Nasal myiasis in leprosy leading to unusual tissue destruction.Nasal mucosal involvement is a constant feature in lepromatous leprosy (1). Granulomatous infiltration of nasal mucosa and consequent sensory loss may result in atrophic rhinitis and or painless ulceration, which is usually asymptomatic except for later complications of epistaxis, septal perforation, inflammation, and/or myiasis in long neglected patients. An unusual destruction of nasal architecture mimicking cancrum oris caused by myiasis in lepromatous leprosy is described for its rarity.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
9/10. Severe pan-sensory neuropathy in leprosy.The sensory loss which occurs in leprosy is essentially cutaneous, resulting from centripetally ascending infection, the host cellular response and fibrosis, from dermal to certain mixed nerves. The hallmark is pain/temperature and touch/pressure loss. muscle denervation is a byproduct of mixed nerve involvement. Leprous sensory and motor neuropathy presents a stereotyped picture, with preservation of position sense, noninvolvement of the large girdle muscles, and retained deep tendon reflexes. We report clinical and investigative details of 7 patients (3 males, 4 females) with mild-to-moderate polyneuritic leprosy who manifested severe proprioceptive loss in the upper per limbs; the lower limbs were similarly affected in 4 of them. Tendon reflexes were absent in the ataxic limbs. No other cause was found for the ataxia. Electrophysiological studies confirmed damage to large cutaneous and muscle afferents, and a normal EMG pattern in hip and shoulder muscles. Of great interest was the histology of a lumbar sensory ganglion biopsied in a severely disabled patient. There was extensive neuron loss and degeneration and reactive proliferation of capsular cells ("nodules of Nageotte"), an inflammatory focus of lymphocytes, and no bacilli. This suggests to us that the proprioceptive loss in these patients could well be the result of an unusual "leprous ganglionitis." Further clarification of the mechanism of ganglion degeneration and the frequency of inflammation could come from immunohistology of tissues from African green monkeys with experimental polyneuritic leprosy.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
10/10. Lid surgery to reduce discomfort produces an unexpected improvement in visual acuity--a case presentation.A significant cause of blindness in leprosy is corneal scarring secondary to corneal anaesthesia and lagophthalmos (Brand & ffytche 1985). Such patients may continue to experience considerable ocular discomfort, particularly when there is associated ectropion of the lower lid, with inflammation of the exposed tarsal conjunctiva (Courtright & Johnson 1991). Where visual outcome is no longer the primary consideration, one may hesitate to subject patients to surgery, particularly in relatively unsophisticated field conditions, attempting instead to relieve the patient's discomfort by conservative treatment such as frequent topical ocular lubricants, use of protective spectacles or eye shades etc. A case is presented here in which minor surgery aimed solely at relieving ocular discomfort resulted in an unexpected improvement in visual acuity. This suggests that there are instances where a more aggressive approach to treatment of even severely damaged eyes could prove more rewarding than anticipated.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
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