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Since morphometric analysis of unmyelinated nerve fibres is lacking in leprosy literature, they were investigated in sural nerves of 2 lepromatous cases. Despite normal or even increased total numbers of unmyelinated axons, tentative differentiation in not-yet-myelinated axons and genuine unmyelinated fibres or their regenerates according to associated Schwann cells and fibre calibres revealed a mild to severe loss of genuine unmyelinated fibres. A predominant involvement, surpassing loss of genuine myelinated fibres, could not be stated in either case. Quantification of degenerating unmyelinated fibres, denervated Schwann cell complexes, and Schwann cell nuclei-both of the unmyelinated type-is also presented and discussed.Since a loss of pain and thermal sensibility with concomitant involvement of peripheral autonomic functionsl constitutes one of the first symptoms in leprosy and remains a characteristic clinical fe ature even in later stages of the disease, unmyelinated nerve fibres deserve special interest. Accordingly, qualitative alterations have been described by several authors, studying nerve biopsies of leprous patients by electron microscopy2 9 or using animal models of the disease. 1 0 1 2 But so far quantitative analysis of unmyelinated fibres is completely missing. There are only short remarks mostly concerning 'loss', 'reduction', 'decrease' or 'depletion',4.6.8.9.1 3.14 rarely even an 'increase' or a 'prominence' is mentioned.8.1 5. 16 Here, we present the results of qualitative and, more interestingly, quantitative electron microscopic studies of the unmyelinated fibre population in 2 treated cases of the lepromatous spectrum. Detailed leprological data and preliminary morphometrical results of case I have been published previouslyY § Professor Klingmiiller has died since the submission of this paper.

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In a case of granulomatous syphilis (transitional state between early and late syphilis), several Langerhans cells (LC) were present in the basal and medial part of the epidermis. Evidence of LC activation was given by the presence of many Langerhans granules, vesicles, a large Golgi apparatus and, sometimes, Golgi complexes. In some LC, signs of degeneration were visible. Langerhans granules surrounded by cytoplasmic material were present in the intercellular space of the epidermis. Apposition of lymphocytes to LC in the dermal space supports the role of LC in immunologic mechanisms. This was further confirmed by signs of phagocytosis in LC. The interaction of LC with intra-epidermal microorganisms (as, for instance, the Treponema pallidum) might be important in the development of the epidermotropic infiltration. This mainly consists of lymphocytes, which sometimes form a pseudolymphoma. A correlation between LC and granuloma formation is suggested.