Aetiopathogenesis of Scleroma

SCLEROMA has been known to affect human beings for nearly a century; von Hebra being the first to report this condition in 1870. He described it as a form of cutaneous cancer. However, the precise pathogenesis of the disease still remains controversial. There are two views: (1) Many authors including Hara et al. (1947); Kauffmann (1948); Levine (1951); support the bacterial theory propounded by Von Frisch (1882), who isolated a Gram negative bacillus from nasal lesions of scleroma patients. (2) Second school of thought believes that the disease is caused by a filterable virus (Cunning and Guerry, 1942; Reyes, 1946; and Zwiefach, 1955). They believe that Klebsiella rhinoscleromatis is a normal commensal in the upper respiratory tract or a secondary invader. Chamberlain (1936) and Putschowsky (1945) observed the course of the disease. The latter divided it into four different clinicopathological stages: (i) early catarrhal stage; (ii) atrophic stage; (iii) granulomatous stage and (iv) fibrotic stage. It is evident that the precise aetiopathogenesis of the condition is far from clear. No mention of control series of bacteriological investigations of the upper respiratory tract is available. The aim of this study is to present the pathological aspects of this condition.