MICROBIAL DISEASES Does not present the clear-cut, well-defined margins seen in the tuberculoid type; the lesions are therefore liable to be mistaken for lepromas. The surface of the lesions is generally smooth, with a shiny appearance and a violaceous hue, sometimes (in light skins) with a brownish (sepia) background.
Microbial Diseases A detailed catalogue of the many contrasts between the two “polar” types of leprosy lepromatous and tuberculoid is given in Table 3.Reactions.
More or less transitory states of exacerbation or reactivation are known as reactions may occur once or repeatedly in all forms of lep-rosy. In lepromatous leprosy, these are known as “lepra reactions,” and two principal forms are recognized.
The lepra reaction may take the form of an atypical, sparse, generalized erythema-nodosum-like reaction, erythema nodosum lep-room, which characteristically occurs when the proportion of dead to living M. leprae rises above a critical ratio.
In tuberculoid or borderline leprosy, reactions, consist of aggravation of nerves may occur; M. Fever and constitutional symptoms (including erythema multiforme) do not occur in tuberculoid cases.
An advanced case of leprosy with the combination of skin lesions and obvious nerve lesions should be readily recognized by the reason-ably alert physician. It is in the early cases, in which the nerve involvement is not readily apparent, that the diagnosis of leprosy may be missed.presence of M. leprae in material obtained from the structure well-preserved Obliteration of normal architectureVisceral amyloidosis Common.