Serum specimens from leprosy patients, their contacts and controls were examined for the presence of phenolic glycolipid I (PGL-I), a Mycobacterium leprae specific antigen, and antibodies to the antigen using enzyme-linked immunosorbent assays. Of 12 lepromatous patients with less than 2 years of therapy, 11(91.7%) were seropositive to PGL-l, thus indicating that new lepromatous cases can be identified by detecting anti-PGL-l antibodies. In contrast 88(56.4%) of 156 lepromatous patiens treated more than 2 years were positve. Moreover, only 69(40.8%) were seropositve among 169 lepromatous patients in the leprosy resettlement villages. The mean antibody level also declined significantly in proportion to the duration of chemotherapy. This may suggest the possibility of monitoring chemotherapy by detecting anti-PGL-l antibodies. The prevalence of anti-PGL-l antibodies among 200 controls from a high endemic area for leprosy was 5.5% and was significantly higher than that(1.5%) among 200 controls from a low endemic area. Of 103 household contacts in the resettlement villages, 10(9.7%) were seropositive, reflecting the frequent chance of exposure to M. leprae. However, PGL-l was not detected many in any of the sera from controls, contacts, and inactive lepromatous patients having the anti-PGL-l antibodies; on the other hand, 6(50%) of 12 lepromatous patients treated less than 2 years had detectable PGL-l in their sera. The results thus indicate that PGL-l detection may be more suitable for monitoring the effectiveness of chemotherapy and that it may be necessary to examine for the presence of PGL-l in sera from contacts and normal populations for confirming M. leprae infection.
Antibodies, Bacterial/*analysis ; Glycolipids/*blood ; Human ; Leprosy/*blood/diagnosis ; Serologic Tests ; Support, Non-U.S. Gov't

BACKGROUND: Pustular eruptions due to drugs are uncommonly reported. We studied the characteristics of clinical and histopathologic findings of pustular drug eruption. OBJECTIVE: We observed th.e causative agents, clinical featurs and histopathologic findings of pustular drug eruption and identified differential points of generlized pustular eruption. METHODS: We evaluated t,he clinical and histopathologic findings of 8 patients with pustular drug eruption and reviewed the literatures reported cases of pustular drug eruption. RESULTS: All patients diagnosed pustular drug eruption suffered from generalized pustular eruption associated with systemic symptoms such as fever, headachened myagia one to three days after treatment with causative agents. The causative agents of putular drug eruption are antibiotics such as ceftriaxone, analgesics and antipyretics. The pustule resolved after a few days of treatment with systemic corticosteroids and antihistamines. Laboratory findings revealed leukocytosis, neutrophilia, and analevated erythrocyte sedimentation rate, On histopatologic findings, we observed subcorneal pustuls containing neutrophils, eosinophils and some lymphocytes and spongiosis, exocytosis of acute iiflammatory cells. Perivascular infiltration of lymphocyte ancl edema of papillary dermis was also bserved in the dermis. CONCLUSION: Pustular drug eruption is characterized by generalized pustular eruption associated with systemic symptoms and histopathologic findings of that are sterile subcorneal pustules. Therefore differential diagnosis of other generalized pustular erupticns are relatively easy by careful history of medication, clinical and histopathologic findings.
Adrenal Cortex Hormones ; Analgesics ; Anti-Bacterial Agents ; Antipyretics ; Blood Sedimentation ; Ceftriaxone ; Dermis ; Diagnosis, Differential ; Drug Eruptions* ; Edema ; Eosinophils ; Exocytosis ; Fever ; Histamine Antagonists ; Humans ; Leprosy ; Leukocytosis ; Lymphocytes ; Neutrophils

BACKGROUND: Pustular eruptions due to drugs are uncommonly reported. We studied the characteristics of clinical and histopathologic findings of pustular drug eruption. OBJECTIVE: We observed th.e causative agents, clinical featurs and histopathologic findings of pustular drug eruption and identified differential points of generlized pustular eruption. METHODS: We evaluated t,he clinical and histopathologic findings of 8 patients with pustular drug eruption and reviewed the literatures reported cases of pustular drug eruption. RESULTS: All patients diagnosed pustular drug eruption suffered from generalized pustular eruption associated with systemic symptoms such as fever, headachened myagia one to three days after treatment with causative agents. The causative agents of putular drug eruption are antibiotics such as ceftriaxone, analgesics and antipyretics. The pustule resolved after a few days of treatment with systemic corticosteroids and antihistamines. Laboratory findings revealed leukocytosis, neutrophilia, and analevated erythrocyte sedimentation rate, On histopatologic findings, we observed subcorneal pustuls containing neutrophils, eosinophils and some lymphocytes and spongiosis, exocytosis of acute iiflammatory cells. Perivascular infiltration of lymphocyte ancl edema of papillary dermis was also bserved in the dermis. CONCLUSION: Pustular drug eruption is characterized by generalized pustular eruption associated with systemic symptoms and histopathologic findings of that are sterile subcorneal pustules. Therefore differential diagnosis of other generalized pustular erupticns are relatively easy by careful history of medication, clinical and histopathologic findings.
Adrenal Cortex Hormones ; Analgesics ; Anti-Bacterial Agents ; Antipyretics ; Blood Sedimentation ; Ceftriaxone ; Dermis ; Diagnosis, Differential ; Drug Eruptions* ; Edema ; Eosinophils ; Exocytosis ; Fever ; Histamine Antagonists ; Humans ; Leprosy ; Leukocytosis ; Lymphocytes ; Neutrophils