TRANSEPIDERMAL ELIMINATION OF LEPROMATOUS GRANULOMA - A MECHANISM FORMASS-TRANSPORT OF VIABLE BACILLI

A 35-year-old male with lepromatous leprosy showed significant progres sion of the disease on initial examination. Along with typical leproma tous skin lesions, many scar-forming lesions were present, mainly on h is extremities. Some lesions showed erosive surfaces. From clinicopath ological findings, these lesions were suspected to be due to the parti al excretion of intradermal lepromatous granulomata by 'transepidermal elimination'. Increased local volume, which might be due mainly to ra pidly growing lepromatous infiltration before chemotherapy, is suspect ed of triggering this phenomenon. There is no doubt that many fresh My cobacterium leprae were included in these excretions. After the initia tion of chemotherapy, no new scar-forming lesions were observed.