The fingers as sites of leprosy bacilli in pre-relapse patients

Abstract

Two dapsone treated patients with apparently quiescent lepromatous leprosy were found to have solid-staining acid-fast bacilli (AFB) in the fingers. The viability of the bacilli from both patients was proved and dapsone resistance was established in one patient by mouse foot-pad inoculation. Subsequently both patients relapsed bacteriologically, one clinically in addition. Thus solid-staining AFB in the fingers, though there may be none seen in skin lesions, may be the prelude to relapse. It is suggested that the dorsum of fingers is a favourable site for persistent bacilli because it is cool and nerve bundles are more superficial there than in most other areas.