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Correspondence |

Endemic Leprosy in New York City

William R. Levis, MD; Lilly-Rose Paraskevas, MD; Mark Jacobson, MD; John Spencer, PhD; Trudy Spencer, RN, MPH; Frank Martiniuk, PhD
Arch Dermatol. 2011;147(5):624-626. doi:10.1001/archdermatol.2011.107.
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Dermatologists at our institution previously identified 2 cases of leprosy in New York, New York, in patients who had never been outside the United States. The first case was a white chemist from Queens, reported in 2000.1 A more recent case was a black man from the Bronx, reported in 2008.2 We report herein a third proven identified case of leprosy in a person who never traveled outside of the continental United States.

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Figure 1.

Biopsy findings from our study patient. A, Infiltrative dermopathy in the biopsy specimen from the right lateral calf (hematoxylin-eosin, original magnification ×4). B, Periadnexal dermal granuloma formation compatible with multibacillary leprosy (hematoxylin-eosin, original magnification ×20). C, Histiocytes with vacuolated, bluish cytoplasms gather around blood vessel, nerve, and adnexal structures through the dermis; within the cytoplasms are numerous acid-fast bacilli (AFB) that stain positive with a Fite stain and, to a lesser extent, with an AFB stain; weak staining of AFB is also seen; the lepromatous pole of leprosy, probably borderline lepromatous, is suggested by this biopsy specimen (Fite stain, original magnification ×40). D, Strong acid-fast Fite staining is seen (red) in many sites (Fite stain, original magnification ×100).

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Figure 2.

Reactivity of lepromatous leprosy (LL) serum samples used as positive controls (LL8, LL27, and LL32) with known high antibody titers. A, Recombinant Mycobacterium leprae protein ML2028 (Ag85B). B, Disaccharide O-linked human serum albumin (ND-O-HSA) (phenolic glycolipid I [PGL-I]). C, M leprae lipoarabinomannan (LAM). 5.25.10NY indicates the subject patient; NEC5 and NEC9, nonendemic healthy control serum samples used as negative controls; OD, optical density. The antigens were tested by enzyme-linked immunosorbent assay using serial 2-fold dilutions of serum from 1:200 to 1:3200. The OD readings were determined with a plate reader at 405 nm.

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