Table Of ContentMYCOBACTERIAL
SKIN
DISEASES
To the memory of my
Father and Mother
who encouraged me to study and
practise the art of medicine;
to my wife
Ina,
and our children
Cita, Reza, Eva, Nanda and Luky
who inspired and supported me
during the preparation of this book.
NEW
CLINICAL
APPLICA TIONS
DERMATOLOGY
MYCO BACTER IAL
SKIN
DISEASES
Editor
MARWALI HARAHAP, MD
Professor of Dermatology
University of North Sumatra
Medical School, Rumah Sakit Pirngadi
Medan, Indonesia
KLUWER ACADEMIC PUBLISHERS
DORDRECHT I BOSTON I LONDON
Distributors
for the United States and Canada: Kluwer Academic Publishers, PO Box 358, Accord
Station, Hingham, MA 02018-0358, USA
for all other countries: Kluwer Academic Publishers Group, Distribution Center, PO
Box 322, 3300 AH Dordrecht, The Netherlands
British Library Cataloguing in Publication Data
Mycobacterial skin diseases.
I. Man. Skin. Mycobacterial diseases
I. Harahap, Marwali II. Series
616.5
ISBN-I3: 978-94-010-7499-5 e-ISBN-13: 978-94-009-2227-3
DOl: 10.1007/978-94-009-2227-3
Copyright
© 1989 by Kluwer Academic Publishers
Softcover reprint of the hardcover 1s t edition 1989
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means, electronic, mechanical,
photocopying, recording or otherwise, without prior permission from the publishers,
Kluwer Academic l\ublishers BY, PO Box 17,3300 AA Dordrecht, The Netherlands.
Published in the United Kingdom by Kluwer Academic Publishers, PO Box 55,
Lancaster, UK.
Kluwer Academic Publishers BY incorporates the publishing programmes of D.
Reidel, Martinus Nijhoff, Dr W. Junk and MTP Press.
CONTENTS
List of authors vii
Guest Editor's Foreword IX
Series Editor's Foreword X
About the Editors xi
1. Tuberculosis and environmental (atypical) myco
bacterioses: bacterial, pathological and immu
nological aspects
J. M. Grange
2. Leprosy: bacterial, pathological, immunological 33
and immunopathological aspects
J. Convit and M. I. Ulrich
3. Tuberculosis of the skin: clinical aspects 79
M. Harahap
4. Environmental (atypical) mycobacteria: clinical 105
aspects
K. J. Tomecki
5. Leprosy: clinical aspects 119
A. C. McDougall
Index 137
v
Other titles in the New Clinical Applications Series:
Dermatology (Series Editor Dr J. L. Verbov)
Dermatological Surgery
Superficial Fungal Infections
Talking Points in Dermatology -I
Treatment in Dermatology
Current Concepts in Contact Dermatitis
Talking Points in Dermatology -Il
Tumours, Lymphomas and Selected Paraproteinaemias
Relationships in Dermatology
Talking Points in Dermatology -Ill
Cardiology (Series Editor Dr D. Longmore)
Cardiology Screening
Rheumatology (Series Editors Dr J. J. Calabro and
Dr W. Carson Dick)
Ankylosing Spondylitis
Infections and Arthritis
Osteoarthritis
Nephrology (Series Editor Dr G. R. D. Catto)
Continuous Ambulatory Peritoneal Dialysis
Management of Renal Hypertension
Chronic Renal Failure
Calculus Disease
Pregnancy and Renal Disorders
Multisystem Diseases
Glomerulonephritis I
Glomerulonephritis Il
H aemodialysis
Transplantation
vi
LIST OF AUTHORS
Jacinto Convit, MD Marwali Harahap, MD
Director, Instituto de Professor of Dermatology
Biomedicina University of North Sumatra
Apartado 4043 Medical School, Rumah Sakit
Professor, Central University Pirngadi
of Venezuela Medan, Indonesia
Caracas 1010 A, Venezuela
A. Colin McDougall, MD, FRCP
John Michael Grange, MD, MSc Consultant in Clinical
Reader in Clinical Research to the British
Microbiology Leprosy Relief Association
National Heart and Lung (LEPRA)
Institute Department of Dermatology
Dovehouse Street The Slade Hospital
London SW3 6LY Headington
Honorary Consultant Clinical Oxford OX3 7JH, England
Microbiologist Previously Leprosy Specialist
National Heart and Chest Ministry of Health, Lusaka,
Hospitals, London Zambia, Africa and Medical
Assistant Editor of Tubercle Specialist, Queen Elisabeth
Hospital, Aden, Federation of
South Arabia
VII
MYCOBACTERIAL SKIN DISEASES
Kenneth Joseph Tomecki, MD Marian Irene Ulrich, PhD
Staff Physician Head, Section of Immunology
Department of Dermatology II
Cleveland Clinic Foundation Instituto de Biomedicina
1 Clinic Center Apartado 4043
Cleveland, OH 44195 Aggregate Professor
USA Central University of
Venezuela
Caracas 1010 A, Venezuela
VIII
GUEST EDITOR'S FOREWORD
We have endeavoured in this book to bring the reader up-to-date
information, which will contribute to an enhanced ability to diagnose
and treat mycobacterial skin diseases.
This volume is mainly concerned with conveying to dermatologists,
microbiologists, immunologists, dermatologists in training, registrars
in other specialties and interested family practitioners, a concise
appraisal of some recent developments in the various aspects of myco
bacterial skin diseases.
The chapters dealing with bacteriology, pathology and immunology
have been planned to appear at the beginning of the book to provide
the necessary conceptual framework for the section on clinical science,
which deals with the variety of clinical states. The value of the clinical
descriptions is vastly enhanced by a careful reading of the earlier
chapters.
The contributing authors have been most cooperative in making
this, the tenth volume in the New Clinical Applications in Dermatology
series, an excellent treatise. I thank each of them for their superb
contributions.
If this book stimulates and encourages a greater interest in, and a
better understanding of, mycobacterial skin diseases, and enables
physicians to serve more effectively those who suffer, the time and
effort spent to produce it will be amply rewarded.
PROFESSOR MARWALI HARAHAP
IX
SERIES EDITOR'S FOREWORD
It was with great pleasure that I heard of Professor Harahap's wish
to produce a volume on mycobacterial skin diseases.
Both he himself and his chosen contributors are experts in the field
of mycobacterial disease and they have combined to produce this
important work which clearly merits a worldwide circulation and a
readership encompassing many disciplines.
JULIAN VERBOV
x
