Bone changes in leprosy under sulfone therapy.

Much success has been reported in the treatment of leprosy within the past seven years from those countries where the sulfone drugs promin, diasone and promizole have been used (1-6). Similarly encouraging therapeutic results have been reported within recent months for another related sulfone called sulfetrone (7). All of these reports seem to indicate that, thus far, the chief value of the sulfones lies in their salutary therapeutic effect on lesions of the skin and mucous membranes. They appear to be able slowly to produce recessive changes in, and healing of, leprous nodules and infiltrations;. to cause disinfection, granulation and healing of leprotic and trophic ulcerations; and gradually to eliminate the leprosy bacilli from such lesions. It is not unreasonable, therefore, to expect that such concomitant lesions as occur in the bones and nerves in leprosy would also in some degree respond to the healing influence of these drugs. What value the sulfones may have in preventing, arresting or healing the bone lesions has not as yet been sufficiently explored. This state of affairs is not due to a lack of scientific interest in this subject on the part of leprologists; it is due to a lack of adequate scientific observation dependent upon the nature of an extremely chronic disease-a disease which is slow in its development and slow in its response to treatment. Apart from the occasional lesions presumably due to the direct action of Mycobacterium leprae, bone changes in leprosy are more or less entirely dependent on neurotrophic disorders which are secondary to nerve involvement (8,9); They manifest themselves mainly in the form of atropic absorption of the small bones of the extremities. Because of the close association be-