Juvenile pemphigus foliaceous: response to dapsone.
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Eleven lepromatous leprosy (LL) patients with a bacterial index (BI) of three and above who had undergone two years of multidrug therapy (MDT) and yet had positive skin smears at the end of treatment were chosen for this study. Biopsies from the skin and lymphnodes were histopathologically evaluated for the presence of granulomas and M. leprae. M. leprae isolated from the skin and lymphnodes were inoculated into the foot-pads of normal mice to test their viability. On histopathological examination of the biopsy specimens, it was found that granulomas and M. leprae were present in the skin and lymphnode biopsies of all patients except two, in whom, although granulomas persisted, M. leprae were not found in skin biopsy specimens. No growth was obtained in the foot-pads of mice inoculated with organisms isolated from skin and lymphnode biopsies of all 11 patients indicating a near complete bacterial kill. That would account for the extremely low relapse rates reported until now in LL patients who had undergne two years of MDT.
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Dapsone/Creatinine in urine ratios were determined in statistically randomised samples of 965 leprosy patients attending out-patient department of Acworth Leprosy Hospital and 44 inmates of the Hospital. The percentage of irregularity in DDS treatment was found in 43 and 22.6 respectively in out-patients and inmates of the Hospital. The need to assess the possible response for irregularity in treatment is stressed and the hazard of infectious cases remaining without treatment or with incomplete treatment is pointed out.
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