M. lepromatosis is the dominant cause of leprosy in Mexico and it co-exists with M. leprae in endemic areas as the once elusive second cause of leprosy. A 41-year-old Madurese woman came with multiple ulcer on her legs, hands and buttock. The ulcers were described as wide and deep, covered with blackish crusts and some exudative area with irregular edges. On face, there were difusse infiltration, madarosis and saddle nose. Histopathology showed thinning of epidermis with a lot of foam cells containing BTA, including endotel and perivascular tissues. Nested PCR examination with LERF2-MLER4 primers for detecting M. leprae showed a positive result. Advanced PCR examination using LPMF2-MLER4 primers for detecting M. lepromatosis also showed a positive result. Based on the clinical, hystopathological results and PCR examination, it was consistent with diffuse lepromatous leprosy. M. lepromatosis mainly causes lepromatous leprosy and also specifically diffuse lepromatous leprosy.

Background: Bacterial vaginosis (BV) is a clinical syndrome caused by the changing of Lactobacillus spp., a producer of hydrogen peroxide, in the normal vagina with a high concentration of anaerobic bacteria, Gardnerella vaginalis and Mycoplasma hominis. This study reports a resistance of BV therapy regimens, high recurrence rates, and side effects of an antibiotic. Therefore, adjunctive therapy for BV management is needed. Research has reported the therapeutic effects of probiotic in BV; however, the results are inconsistent. Purpose: To evaluate the efficacy of standard therapy using metronidazole and Lactobacillus plantarum for BV measured by the cure rate and vaginal flora balance. Methods: A randomized, double-blind, placebo-controlled trial, 30 subjects were randomized to take metronidazole 500 mg twice a day for seven days with weekly evaluation. The Lactobacillus plantarum or placebo group was evaluated every 4 weeks. The cure rate and vaginal flora balance were evaluated using the Amsel criteria and Nugent score before and after the intervention. Result: A total of 30 subjects returned for 28-day follow-up, of which 60% subjects of the antibiotic/probiotic group were cured compared to 40% in the antibiotic/placebo group (p>0.05). Conclusion: There was no difference in the increase of cure rate and vaginal flora balance between the treatment group and significant control group.