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November 1954

SPECIFIC TISSUE ALTERATION IN LEPROUS SKINVI. "Isopathic Phenomenon" Following BCG Vaccination in Leprous Patients

AMA Arch Derm Syphilol. 1954;70(5):631-639. doi:10.1001/archderm.1954.01540230081010

IN THE skin of leprous patients a focal characteristic histological lesion developed at the site of injection of specific and nonspecific proteins. It was found that the injection of tuberculin, leishmanin, milk, and peptone elicited a lepromatous or prelepromatous structure characteristic of lepromatous leprosy.* The injection of these materials into the skin of normal persons elicited a nonspecific inflammation totally different from the lesion which developed in leprous patients. Lepromatous and prelepromatous structures were also noted to have developed in lepromatous leprosy patients at the site of insect bites and of erythema-nodosum-like eruptions appearing during chemotherapy.3 These observations indicated that the skin of leprous patients has a specific altered reactivity.

A study of the reaction of leprous skin to living organisms was desirable. For several reasons BCG inoculation was selected. First, it has been reported that BCG inoculation might protect against infection with leprosy in healthy contacts.