Ultrastructural aspects of oral and facial lepromatous lesions

The ultrastructure of 10 lepromatous lesions in the face and the palatal mucosa after different duration and length of treatment was studied. Biopsies taken from patients who showed erythema nodosum leprosum (ENL) revealed different ultrastructural characteristics from those taken from ‘burnt out’ and non-medicated cases. Multiple secondary lysosomes were rarely seen in non-ENL cases. The presence of Mycobacterium leprae and an increased lysosomal activity in ENL reactive cases is interpreted as a reaction to the lysis of the cytoplasmic matrix of M. leprae; however, drug-specific (diaminodiphenylsulphone) reactions must also be considered.