Pathogenesis of Leprosy and Related Diseases (eBook)

Front Cover 1
Pathogenesis of Leprosy and Related Diseases 4
Copyright Page 5
Table of Contents 10
Foreword 6
Preface 8
Acknowledgments 9
Abbreviations 13
Chapter 1. Introduction 14
The study of pathogenesis 14
The calibration of a histological picture 15
References 16
Part I: General considerations 18
Chapter 2. The structure of skin 20
The skin biopsy 20
The normal skin 21
References 26
Chapter 3. The structure of peripheral nerve 28
Microanatomy 28
Response to disease 30
References 31
Chapter 4. Inflammation 33
Inflammatory cells 33
Acute and chronic inflammation 41
Granuloma formation 43
Necrosis and fibrosis 47
Immune complexes and inflammation 49
References 50
Chapter 5. Concepts of the spectrum 52
Types of spectrum 52
The spectrum of leprosy is unique 53
References 54
Part II: Leprosy 56
Chapter 6. The leprosy bacillus 58
Growth characteristics 58
Morphology and constitution 59
References 62
Chapter 7. The disease called leprosy 65
Introduction 65
The pathogenesis of the clinical picture 67
Immunology 69
References 72
Chapter 8. The early skin lesion of leprosy 74
The evolution of the lesion 74
Protected and optimal sites 76
The portal of entry 80
References 82
Chapter 9. Neuropathy in leprosy 84
The pathway of nerve involvement 84
The neuropathology of leprosy 85
The pathogenesis of the lesion 88
Neural affinity, immunological protection and autoimmunity 91
References 93
Chapter 10. Leprosy as a systemic disease 97
Respiratory tract 97
Vascular disease 99
Reticuloendothelial system 100
Other organs and tissues 101
References 103
Chapter 11. Nature of the leprosy spectrum 106
Basis of the Ridley-Jopling classification 106
Immunopathology of the spectrum 109
Evolution of the response 113
References 117
Chapter 12. Activity of the infection 119
Phases of bacterial multiplication 119
The macrophage cycle 121
Viable and dead bacilli 125
Reactivity and relapse 128
References 129
Chapter 13. Reactions 131
Type 1 (borderline) reactions 131
Erythema nodosum leprosum 136
Exacerbation reactions 143
References 145
Chapter 14. The defect in leprosy 148
Epidemiological considerations 149
Genetic inheritance 150
Portal of entry 151
The evolution of the response 152
Immunosuppression 154
References 156
Chapter 15. Histological diagnosis 158
Principles of diagnosis 158
Early lesions 159
Tuberculoid lesions 164
Differentiation of reaction and relapse 166
References 167
Chapter 16. Classification 168
Histological classification in nerve 181
References 184
Part III: Related diseases 186
Chapter 17. Leishmania and leishmaniasis 188
Speciation and form of disease 188
The spectrum of cutaneous leishmaniasis 191
References 192
Chapter 18. Leishmaniasis: the tissue response 194
Onset of the infection 194
General pathology of cutaneous leishmaniasis 195
Alternative modes of evolution 198
Mucocutaneous leishmaniasis 204
Visceral leishmaniasis 206
Conclusion 206
References 206
Chapter 19. Leishmaniasis: pathogenesis 209
Mechanisms of parasite elimination 210
Immunosuppression 216
References 217
Chapter 20. Tuberculosis and its pathology 220
The tubercle bacillus 220
General pathology 221
The spectrum of tuberculosis 223
References 229
Chapter 21. Pathogenesis of tuberculosis 231
Mechanisms of necrosis 232
Killing mechanisms 236
References 237
Chapter 22. Some other granulomas 239
Other mycobacterial granulomas 239
Granulomas of unknown aetiology 240
Granulomas due to known molecules 242
Modes of cell death 244
References 245
Chapter 23. Determinants of the course of infection 247
Appendix: Technical methods 251
Fixation of tissues 251
Staining of organisms in sections 252
Identification of antigen in tissues 254
References 257
Index 258