LEPROSY is an ancient disease, known from South Asia since at least 2000 BCE. While there is no physical evidence of this disease in the region before about 50 CE, five different words are translated as “LEPROSY” in Mesopotamian texts and some of them occur frequently. Based on the texts, one word (garaSu) is rarely used and there is evidence that the other four words relate to diseases that were treated, could be cured and, did not always require that affected individuals be permanently excluded from society. From this we conclude that the four commonly seen words do not describe modern LEPROSY. Three words (saHarasubbu, epqu, garabu) also signify “scales” or “scabs”, which naturally prompts the speculation that they are skin diseases more serious than eczema. The final word (busanu) has been associated with several modern diseases, but the common feature appears to be a bacterial infection affecting the skin, mouth and nose.

BACKGROUND: Because of the long incubation period of LEPROSY and disability caused by it, even mother to fetus transmission has been reported. Thus, this disease causes much alarm. Kurdistan Province, which is located in the Western part of Iran, is one of the regions that have previously suffered from endemic LEPROSY. The aim of the present study was to investigate the effects of the LEPROSY elimination campaign (LEC) on LEPROSY case finding in Baneh, Iran, in 2012. METHODS: This case series study was conducted in Baneh District. Case finding was performed via LEC method, which is a recommended method for LEPROSY case finding in endemic areas. The performed steps included public education, and screening families of ex-patients through careful examination, identification of suspected cases, and diagnosis based on specialist’ s examination. RESULTS: The families of ex-patients were assessed and 76 people who had prolonged exposure to ex-patients were invited to be examined by a trained general physician. Subsequently, 50 people were referred to a dermatologist for further examinations, 5 of whom and 1 unexposed person underwent bacteriological test for further evaluation. The results of all the tests were negative. CONCLUSION: Active LEPROSY case finding and use of LEC method require a great deal of money and efforts to identify a small number of patients. Because a district like Baneh is in the process of eliminating LEPROSY and since the economic and social situation has changed greatly over the past two decades, LEC method is no longer cost effective.

Multiple sclerosis (MS) is widely believed to be an autoimmune disorder. Another exciting idea regarding the aetiology of MS may be that the immune response in MS could result from a chronic infection rather than autoimmunity in the usual sense. M. leprae-induced myelin damage in the early infectious process provides valuable insights into the pathologic mechanisms of multiple sclerosis. However, no research has hypothesized the possible involvement of mycobacterium leprae or its components in pathogenesis of MS. Most of the antigens of mycobacterium leprae and mycobacterium tuberculosis are members of stress protein families. Of the M. leprae and M. tuberculosis antigens identified by monoclonal antibodies, all except the 18-kDa M. leprae antigen and the 19-kDa M. tuberculosis antigen are strongly coded with very similar genes. I hypothesize that MS is a syndrome of diseases, induced by intradermal BCG vaccine which may contain the antigen component resembling that of leprae that can either produce central demyelination by itself, or by delayed hypersensitivity. The hypothesis should be assessed in several experimental and clinical trials. If my hypothesis can be verified experimentally and clinically, then measurements to prevent MS disease could be accomplished.

A 55-year-old man presented with a six month history of widespread pruritic plaques. He had been treated with several topical steroids, with a possible diagnosis of subacute dermatitis without any improvement. His medical history was unremarkable and he had no known contact with other people similarly affected. Physical examination revealed generalized erythematous infiltrative plaques on his trunk and limbs (Figure 1). The plaques were non-tender and had normal sensation. No nerve enlargement or neurologic impairment was detected. He had no lymphadenopathy. Physical examination was otherwise normal. Routine hematological and biochemical investigations were within normal ranges. The chest X-ray was unremarkable…..

Background: Langerhans cells are important in the pathogenesis of LEPROSY. A recent study reported that these cells were almost absent in the epidermis overlying lepromatous lesions. Objective: To investigate a possible relationship between the number of Langerhans cells and the histopathologic spectrum of lesions in patients with LEPROSY. Methods: An immunohistochemical staining for S100 protein was used to study skin punch biopsies of patients with LEPROSY and to quantify S100-positive Langerhans cells in the epidermis. Results: A progressively significant reduction in the number of Langerhans cells was found from tuberculoid to lepromatous skin lesions. Langerhans cells were significantly less frequent in lepromatous and borderline lepromatous as compared to either tuberculoid or borderline tuberculoid LEPROSY. Conclusion: In view of the fact that adequate numbers of dendritic cells are recruited to the dermis, their maturation/ migration to Langerhans cells in the epidermis is impaired in lepromatous LEPROSY.