02457nas a2200289   4500000000100000008004100001260001300042653000900055653002000064653001400084653001100098653002600109653001200135653000900147653002500156653001700181100001300198700001300211700001000224700001300234700001200247245010400259300001100363490000700374520177200381022001402153       1995                            d  c1995 Nov10aAged10aEpidermal Cells10aEpidermis10aHumans10aKeratosis, Seborrheic10aleprosy10aMale10aMycobacterium leprae10aPhagocytosis1 aYajima M1 aSuzuki K1 aWen M1 aYamada N1 aAsano G00a[Intraepidermal mass of M. leprae in a case of seborrheic keratosis due to Hansen's disease (LLs)].  a236-450 v643 a<p>A 67-year-old patient has had exanthema in the lower right limb since 51 years ago (16 years old at onset), which underwent repeated remission and recurrence. At present, he has bilateral symmetrical widespread infiltrating exanthema and asymmetrical marked neuralhypertrophy, and has been diagnosed typical LLs (His father had the same disease). The exanthema recurred several years ago, and the patient is being treated for Hansen's disease. He had a dark brown flat elevation with a rough surface and the size of a small finger tip in his right abdominal skin for approximately 20 years. A biopsy was performed, and the specimen was fixed in 10% formalin and paraffin sections were prepared for histopathologic examination. A part of the specimen was processed forscanning electron microscopic examination. Seborrheic keratosis was diagnosed by H & E staining. Acid-fast (FITE) staining, immunohistochemical staining (keratin, S-100 protein, anti-PGL antibody and anti-BCG antibody) and scanning electron microscopy revealed the presence of bacteria (M. leprae) in the dermal foam cells, the matrix with a banded structure and the squamous epithelial cells which normally lack phagocytosis function. Compared to the basal cells of normal epidermis, the basal cells located adjacent to the dermis affected with seborrheic keratosis showed increased proliferation and more marked characteristics of a germinative cell. The degree of differentiation of the basal cells appeared regressed, and they probably possessed augmented phagocytic activity. The phagocytosed bacteria were probably carried by the epidermal cell cycle toward the surface layer. However, bacteria could not be found in the stratum corneum, probably due to an association with the lysosome.</p>  a0386-3980