Leprosy Mailing List – October 9th, 2007
Ref.:
World Congress
of Dermatology, Buenos Aires, Argentina, September 30th to October
5th, 2007
From: Ryan T., Oxford, UK
Dear
Salvatore,
If
Dermatology is to play a significant role in leprosy control in the
future one must look for signs that it is maintaining interest. The quinquennial World
Congress of Dermatology in Buenos Aires September 30th to October 5th
was attended by about 14000 participants and there were more tha12,000
abstracts. 66 of these
were on leprosy and there were unsurprisingly a majority from South
America.
Dermatologists
like to record unusual presentations and the difficulty of diagnosing
leprosy was frequently emphasised especially in children. Concern was expressed at how
frequently single lesions proved to be multibacillary and a policy of
not taking smears would result in too little therapy. From South America the Lucio
Phenomenon was frequently described. Several
cases of Histioid Leprosy were described unrelated to dapsone
resistance. Rifampicin
resistance “in many parts of the world” is a threat. Leprosy and cutaneous TB with
leprosy in the same subject was not rare.
In a
five day congress there are few plenary lectures but Sinesio Talhari
was given the floor for one of these. He
emphasised that leprosy had not vanished but manipulation of figures
had made it seem so. Many
other presentations spoke of increasing numbers in many low endemic
countries.
Neuropathy
was addressed in a thorough validation of the Semmes-Weinstein
Monofilament Test and by advocacy of the use of ultrasound for nerve
thickening.
Dermatologists
have been advocates of telemedicine and now the mobile phone in every
household offers opportunities. I
suspect anyone transmitting a digital image has passed the essential
first step to diagnosis which is to think of it.
Considering
the huge experience of HIV/AIDs there were very few papers on an
interaction with leprosy and the experience of any one observer was no
more than two or three. A
first appearance after transplantation and the effect of the now
frequent ‘biologicals’ used to treat autoimmune disease received
emphasis.
V
Pannikar’s abstract could be read “We can expect a world with a
reduced burden of leprosy, reduced stigma and discrimination,
activities based on principles of equity and social justice and strong
partnership based on equality and mutual respect at all levels”. He was not present for a large
audience to question these premises.
Terence
Ryan
