Clinical, immunological and histological aspects of an uncommon type II reaction in patients with lepromatous leprosy Journal Article
| Authors: | Esquenazi, D.; Moreira, A. L.; Miranda, A.; Nery, J. A. C.; Alvarenga, F. F.; Sarno, E. N.; Pereira, G. M. B. |
| Article Title: | Clinical, immunological and histological aspects of an uncommon type II reaction in patients with lepromatous leprosy |
| Abstract: | This study reports three cases of an unusual leprotic reaction characterized by superficial bullous ulcerative cutaneous lesions associated with high fever, malaise and oedema in patients with leprosy. Two patients responded to thalidomide treatment, with regression of the symptoms and skin ulcers. The third patient responded to thalidomide plus prednisone. Analysis of the ulcerated skin lesions showed dermal oedema with mononuclear cell infiltrate enriched for γδ-positive T lymphocytes and an increased number of Mycobaterium leprae bacilli within capillary endothelium. In contrast, γδ+ cells were decreased in or absent from the blood. Tumour necrosis factor-α and interleukin-6 were raised in the serum of the patients at the onset of the reaction. After the episode, cytokine levels and the percentage of γδ+ cells in the blood returned to normal. These cases characterize an uncommon leprotic reaction with clinical similarities to type II reaction and may indicate a significant role for γδ+ T cells in its pathogenesis. © 2008 The Author(s). |
| Keywords: | immunohistochemistry; adult; human tissue; treatment outcome; treatment response; aged; middle aged; human cell; prednisone; thalidomide; clinical feature; histopathology; case report; follow up; t lymphocyte; t-lymphocytes; protein blood level; disease association; skin biopsy; cell infiltration; fever; malaise; tumor necrosis factor alpha; mononuclear cell; tumor necrosis factor-alpha; paracetamol; interleukin 6; remission; skin ulcer; antiviral agents; leprosy; skin edema; erythema nodosum; interferon type ii; isometheptene; bacterial count; capillary endothelium; erythema nodosum leprosum; lepromatous leprosy; mycobacterium leprae; vesicular rash; leprosy, lepromatous |
| Journal Title: | Clinical and Experimental Dermatology |
| Volume: | 33 |
| Issue: | 3 |
| ISSN: | 0307-6938 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2008-05-01 |
| Start Page: | 294 |
| End Page: | 297 |
| Language: | English |
| DOI: | 10.1111/j.1365-2230.2007.02654.x |
| PUBMED: | 18261142 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Export Date: 17 November 2011" - "CODEN: CEDED" - "Source: Scopus" |
