FIG 7.

Histopathological progression of cutaneous lesions in type 1 reactions. (A) The initial skin biopsy specimen revealed features of borderline lepromatous leprosy, with a disorganized inflammatory infiltrate in which vacuolated macrophages predominated. Occasional multinucleated giant cells were also noted. Fite stains revealed moderate numbers of bacilli (inset and thin bold arrow). (B) A biopsy specimen 1 month later revealed greater organization of the inflammatory infiltrate and increased lymphocytic clustering, with more numerous multinucleated giant cells, consistent with a type 1 leprosy reaction (thick dotted arrow) (original magnification for photographs of hematoxylin- and eosin-stained sections, ×250; original magnification for photographs of Fite-stained sections, ×1,000). (Adapted from reference 100 by permission of Oxford University Press and the Infectious Diseases Society of America.)