Early lesions in disseminated reactional cases

Abstract

Authors studied 50 patients with disseminated reactional lesions and classified both as reactional tuberculoids and reactional borderline (type I reaction of Jopling ). After careful story taking and clinical and dermatological examination, it was clear that all of them had similar clinical story as regards the beginning of the disease, regardless of the immunological grade. The initial lesions (mother lesions) are hypo chromic macules or circumscribed areas of normal color skin with some sensory impairment, which should not be misinterpreted as those reported by Wade that circumscribe Immune areas". These lesions seems to precede a phase of bacillemia with destruction of bacilli, in the place they are, and the liberation of antigens with the consequent manifestation of delayed hypersensitivity, which is the reactional episode. Treatment would have some role to play only in those cases with low immunity and , thus, prone to new reactional episodes. Without treatment, these patients would continue to present new reactional episodes indefinitely.