01645nas a2200337   4500000000100000008004100001260001300042653001000055653001900065653001300084653002400097653001100121653002300132653002500155653000900180653002500189653000900214100001500223700001300238700001400251700001200265700001200277700001200289245010700301856005900408300001100467490000700478050003200485520077600517022001401293       1997                            d  c1997 Jun10aAdult10aBiopsy, Needle10aCicatrix10aDisease Progression10aHumans10aLeprostatic Agents10aLeprosy, lepromatous10aMale10aMycobacterium leprae10aSkin1 aNamisato M1 aKakuta M1 aKawatsu K1 aObara A1 aIzumi S1 aOgawa H00aTransepidermal elimination of lepromatous granuloma: a mechanism for mass transport of viable bacilli.  uhttp://leprev.ilsl.br/pdfs/1997/v68n2/pdf/v68n2a10.pdf  a167-720 v68  aInfolep Library - available3 a<p>A 35-year-old male with lepromatous leprosy showed significant progression of the disease on initial examination. Along with typical lepromatous skin lesions, many scar-forming lesions were present, mainly on his extremities. Some lesions showed erosive surfaces. From clinicopathological findings, these lesions were suspected to be due to the partial excretion of intradermal lepromatous granulomata by 'transepidermal elimination'. Increased local volume, which might be due mainly to rapidly growing lepromatous infiltration before chemotherapy, is suspected of triggering this phenomenon. There is no doubt that many fresh Mycobacterium leprae were included in these excretions. After the initiation of chemotherapy, no new scar-forming lesions were observed.</p>  a0305-7518