Book review
Harada, Kyoshi. Biopsy of Skin Lesions in Leprosy; Stains, Pathogenesis and Classification. Tokyo, 1995. Softbound, 72 pages. From: Kiyoshi Harada, M.D., Nukuikitamachi 5-30-14, Koganei, Tokyo 184, Japan.
This monograph is a collection of loosely organized chapters by one author, dealing with a wide range of subjects related to the histopathologic appearances of leprosy in skin biopsies. The diverse subjects are dealt with in varying depth: Some of the chapters present reviews of the literature, e.g., the "pathogenesis of a skin lesion," while other chapters present a detailed review of the history of the development of systems for the classification of leprosy and the systems used currently. The author is well known for his expertise in the histochemistry of acid-fast organisms, and the chapters dealing with staining techniques include bench protocols for several methods.
This is largely a polemic presentation on the merits of the periodic acid carbol pararosanaline (PA-CPR) technique for the staining of mycobacteria, which the author has described in previous publications. The results using this and other methods are very nicely illustrated in numerous, high-quality photomicrographs, the fine technique of which will arouse the envy of many histotechnologists and pathologists who have endeavored to produce such clear results in acid-fast staining. These illustrations are the heart of the monograph, and its most recommended feature. The author proposes that the PA-CPR method stains a greater number of Mycobacterium leprae in a wide variety of tissues and types of leprosy lesions, and this argument can be followed best by examining the photos and their captions.
The text, unfortunately, is more difficult to follow. It has apparently suffered from a lack of editing by a native English speaker, and as a result contains errors in spelling, grammar, and syntax which make it difficult to follow. These difficulties interfere less in the sections which present the historical development of leprosy classification and of acid-fast staining techniques. For these subjects this is a useful, concise source. For practical issues of classification, however, the inclusion and comparison of several different classification schemes makes the text overly detailed. For anyone beginning to learn the histopathologic classification of leprosy, or anyone referring to it occasionally to "brush up" on the subject, this treatment will probably be unnecessarily confusing.
This monograph has a place on the bookshelf in laboratories involved regularly in the staining of tissues for the demonstration of acid-fast organisms. In this setting its high-quality illustrations and detailed staining protocols will be appreciated. The monograph is not for the beginner, however, and is not likely to be too useful as a primer or reference in laboratories which use acid-fast stains infrequently.
- David M. Scollard, M.D., Ph.D.
Chief, Research Pathology
Laboratory Research Branch
GWL Hansen's Disease Center at Louisiana State University
P.O. Box 25072
Baton Rouge, LA 70894, U.S.A.