Background: Patients with 1 to 5 skin lesions are arbitrarily categorized as belonging to the paucibacillary (PB) group for treatment purposes. With the decreasing prevalence of leprosy in India and modifications in leprosy program, the relevance of this grouping needs further study.
Aims: To study a group of leprosy patients with 1 to 5 skin lesions and compare the clinical parameters with histopathological findings and bacteriological status of the skin and nerve to evaluate the relevance of this grouping.
Methods: Seventy seven patients of leprosy with 1 to 5 skin lesions were included in the study. The number of skin lesions was recorded. Slit skin smears (SSS) and skin biopsies were taken in all patients and nerve biopsy was performed in 19 of them. The biopsies were evaluated for the type of pathology and AFB status.
Results: In these 77 patients (single skin lesions, 42; two lesions, 18; three lesions, 10; four lesions, 5; and five lesions, 2 patients) the clinical classification was indeterminate leprosy (IL) in 4, tuberculoid leprosy (TT) in 4 patients and borderline tuberculoid leprosy (BT) in 69 patients. Skin smears were positive only in 1 patient. The histological diagnoses in the skin were IL in 13, TT in 3, BT in 48 and borderline lepromatous (BL) in 4 patients. Acid-fast bacilli (AFB) were found in 14 out of 77 skin biopsies. Of the 19 nerve biopsies, 17 showed histological features of BT leprosy; of these, 12 demonstrated AFB on Fite staining. The bacillary index of granuloma (BIG) ranged from 1+ to 2+. The clinico-histopathogical correlation was 63% in the BT group, with 4 patients of this group showing features of BL on histopathology. When the presence of AFB was assessed, the percentage of positivity was 1.3% in SSS, 18% in skin biopsies and 63% in nerve biopsies.
Conclusion: Our results point to the non-homogeneous nature of this group of leprosy patients with 1 to 5 skin lesions, with varied bacteriological and histopathological features. The significance of MB type findings on histopathology in patients grouped as PB leprosy should be resolved so that these patients may be given the drug therapy and the duration of therapy they warrant.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.4103/0378-6323.25781 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Spectrum of Dermatoses Affecting the Lower Leg and Foot in an Outpatient Clinic at a Tertiary Care Hospital.
Adv Skin Wound Care
January 2025
At ESIC Medical College & Hospital, Faridabad, Haryana, India, Shanta Passi, MD, is Associate Professor, Department of Dermatology, Venereology, & Leprology; Deepika Uikey, MD, is Assistant Professor, Department of Dermatology, Venereology, & Leprology; and Manoj Kumar, MD, is Assistant Professor, Department of Psychiatry.
Background: Infective and noninfective dermatoses of the lower leg and foot can be attributed to factors such as infections, blood stagnation, chemical contact, and abnormal mechanics. These factors make the lower leg and foot more susceptible to microbial infections, contact dermatitis, stasis eczema, ulcers, corns, and calluses.
Objective: To identify the patterns of infective and noninfective dermatoses on the lower leg and foot.
Conservative Reconstruction of the Lower Limb with a Bilayer Porous Collagen Matrix after a Spider Bite.
Adv Skin Wound Care
January 2025
Marco Palmesano, MD, is Plastic Reconstructive and Aesthetic Surgeon, PhD Program in Applied Medical Surgical Sciences, University of Rome Tor Vergata, Rome, Italy. Davide Johan Bottini, MD, PhD, is Consultant in Maxillofacial Surgery, Policlinico Casilino Hospital, Rome. Also at University of Rome Tor Vergata, Gabriele Storti, MD, is Researcher and Consultant in Plastic Surgery; Lorenzo Secondi, MD, is Plastic Reconstructive and Aesthetic Surgeon, PhD Program in Applied Medical Surgical Sciences; and Carlo Cossi, MD; Alessio Calicchia, MD; Martina Giacalone, MD; and Irene Nunziata, MD, are Plastic Surgery Residents. Emanuela Basile, MD, is Consultant in Maxillofacial Surgery, Policlinico Casilino Hospital. Valerio Cervelli, MD, is Full Professor and Chief, Department of Plastic Surgery, University of Rome Tor Vergata.
Brown recluse spider bites may cause symptoms ranging from local cutaneous reactions to systemic visceral loxoscelism. Most bites are self-limiting, but some can lead to necrotic ulcerations with severe complications and soft tissue defects. Necrotizing ulcers are uncommon and have various clinical presentations, so no standard treatment exists.
View Article and Find Full Text PDFPyoderma Gangrenosum Improved with Dapsone and Prednisone: A Case Report.
Adv Skin Wound Care
January 2025
Arbie Sofia P. Merilleno, MD, DPDS, is an Inflammatory Disease Fellow, University of Toronto, Ontario, Canada; Clinical Fellow, Women's College Hospital, Ontario; and Research Fellow, Women's College Research Institute, Ontario. Charlene Marie Ang-Tiu, MD, FPDS, is Medical Specialist, Rizal Medical Center, Pasig City, Philippines.
Pyoderma gangrenosum is a rare ulcerative condition that poses diagnostic and therapeutic challenges. Diagnosis and appropriate management are often delayed due to its rarity and the presence of numerous clinical variants. In this case report, the authors present the case of a 36-year-old man who had long-standing and nonhealing ulcers that did not respond to multiple antibiotics and serial wound debridement.
View Article and Find Full Text PDFStudy of cathelicidin (LL-37) immunoexpression in the skin of vitiligo patients.
Arch Dermatol Res
January 2025
Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Vitiligo is a pigmentary disorder acquired and caused by the loss or destruction of melanocytes from the epidermis. There is strong proof that vitiligo is mainly an autoimmune disease. Cathelicidin (LL37), an antimicrobial polypeptide, is an important part of the innate immune system and has a role in different skin autoimmune diseases.
View Article and Find Full Text PDF[WHO classification of melanocytic tumours].
Dermatologie (Heidelb)
January 2025
MVZ Dermatohistopathologie Heidelberg, Mönchhofstr. 52, 69120, Heidelberg, Deutschland.
Background: The update of the World Health Organisation (WHO) classification of skin tumours has led to new aspects in the classification of melanocytic tumours.
Objectives: Presentation of the classification of melanocytic tumours in light of current clinical, histological and genetic data.
Materials And Methods: Review of the classification of melanocytic neoplasms in the fifth edition of the WHO classification of skin tumours, taking into account current disease concepts.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!