Comparative study of the cutaneous sensation of leprosy-suspected lesions using Semmes–Weinstein monofilaments and quantitative thermal testing

Villarroel, Manoel F.; Orsini, Maria Beatriz Penna; Lima, Ronise C.; Antunes, Carlos

doi:10.47276/lr.78.2.102

Cited by 27 publications

(4 citation statements)

References 20 publications

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“…Assessment of sensitivity with Semmes-Weinstein monofilaments shows excellent agreement with electromyography findings alone 2,24,25 or when combined with palpation of the peripheral nerves to detect swelling and inflammation. 22 Although some studies of leprosy patient skin lesions suggest a sequential loss of thermal sensitivity, followed by loss of pain and later tactile sensation, Villarroel et al 26 examined tactile sensitivity with monofilaments and compared the results to those obtained with thermal sensitivity tests in suspected leprosy patients, finding that some individuals had a loss of tactile sensitivity with either 0.05 g force or 0.2 g force monofilaments that preceded the change in thermal sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Semmes-Weinstein monofilament: A tool to quantify skin sensation in macular lesions for leprosy diagnosis

Frade¹,

Rosa²,

Filho³

et al. 2021

IJDVL

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Introduction: Hypochromatic macules with altered sensitivity are the first manifestations of skin leprosy. Validation of this sensory loss assists in the confirmation of the clinical diagnosis. Aims: The aim of the study was to quantify the loss of sensation in leprosy lesions using the Semmes-Weinstein monofilament to strengthen the clinical diagnosis mainly of macular forms. Methods: Seventy-four hypochromatic macules in the macular leprosy subgroup, 27 typical borderline leprosy subgroup lesions and 49 macules of other macular dermatoses (non-leprosy group) were evaluated using the 0.05 g force Semmes-Weinstein monofilament to quantify the alteration of sensitivity within and outside of the lesions. The esthesiometric change index was established as the total number of points with altered sensation divided by the total number of tested points within the lesions to calculate the internal esthesiometric change index and outside the lesions to calculate the peripheral esthesiometric change index; these indexes were calculated for all groups. The difference (Δ) between the esthesiometric change indices of the lesional area and the adjacent skin was calculated for the leprosy and nonleprosy groups. Results: The percentage of points with touch sensitivity alterations within the macular and typical borderline leprosy lesions was higher in leprosy than in the non-leprosy group. The borderline and macular leprosy presented higher esthesiometric change index within injured areas than outside injured areas or in the nonleprosy group (P < 0.005). When internal esthesiometric change index values in the macular and borderline leprosy groups were higher than 0.53 and 0.5, respectively, the receiver operating characteristic curve showed 98% sensitivity and approximately 99% specificity for both groups (P < 0.0001). Regarding the difference between indices, borderline and macular leprosy had values that were higher and closer to one than in the nonleprosy group (P < 0.0001), with 100% sensitivity and 96.5% specificity for leprosy diagnosis when ΔLG was higher than 0.34. A limitation was the inability to perform a double-blind study. Conclusion: Semmes-Weinstein esthesiometry is a simple, useful and low-cost tool to quantify the focal alteration of cutaneous sensitivity to improve clinical leprosy diagnosis, especially for macular lesions.

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Section: Discussionmentioning

confidence: 99%

Semmes-Weinstein monofilament: A tool to quantify skin sensation in macular lesions for leprosy diagnosis

Frade¹,

Rosa²,

Filho³

et al. 2021

IJDVL

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“…The diagnosis of leprosy was conducted with the well-accepted clinical signs and symptoms based on the Ridley-Jopling classi cation, including detection of hypopigmented or in ltrated skin lesions with loss of sensation assessed with standard graded Semmes-Weinstein mono laments and the palpation of peripheral nerves to identify characteristic pain associated with in ammation or swelling, as previously described [29,30].…”

Section: Clinical and Laboratory Diagnosismentioning

confidence: 99%

Whole Mitogenome Sequencing Uncovers a Relation Between Mitochondrial Heteroplasmy and Leprosy Severity

de Souza,

Silva,

de Araújo

et al. 2023

Preprint

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Background In recent years, a mitochondria/immune system interaction has been proposed, so that variants of mitochondrial genome and levels of heteroplasmy might deregulate important metabolic processes in fighting infections, such as leprosy. We sequenced the whole mitochondrial genome to investigate variants and heteroplasmy levels, considering patients with different clinical forms of leprosy and household contacts. Results We found 116 variants in at least two of the subtypes of the case group (Borderline Tuberculoid, Borderline Lepromatous, Lepromatous), suggesting a possible clinical significance to these variants. Notably, 15 variants were exclusively found in these three clinical forms, of which five variants stands out for being missense (m.3791T > C in MT-ND1, m.5317C > A in MT-ND2, m.8545G > A in MT-ATP8, m.9044T > C in MT-ATP6 and m.15837T > C in MT-CYB). In addition, we found 26 variants shared only by leprosy poles, of which two are characterized as missense (m.4248T > C in MT-ND1 and m.8027G > A in MT-CO2). Conclusion We found a significant number of variants and heteroplasmy levels in the leprosy patients from our cohort, suggesting for the first time that the mitogenome might be involved with the leprosy process, distinction of clinical forms and severity. Thus, future studies are needed to help understand the genetic consequences of this variants.

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“…Peripheral centres generally use the tip of a ballpoint pen (to test light touch), while many tertiary referral centres make use of cotton wool (for light touch), as well as the point of a sterile needle (for pain), and cold (25 °C) and warm water (40 °C-45 °C as per various studies) in test tubes (for temperature), to detect sensory impairment. 3,4 But these traditional methods are not standardised.…”

Section: Introductionmentioning

confidence: 99%

“…The authors concluded their study with the opinion that smaller and cheaper devices that can assess thermal perception need to be developed and at present monofilaments have adequate validity as a diagnostic tool in leprosy. 3 In a study comparing the ballpoint pen with the monofilaments to detect sensory perception of hands and feet, the former was found to be less reliable. 6 Sensory nerve function impairment affecting hands and feet in leprosy is denoted as Grade1 disability.…”

Section: Introductionmentioning

confidence: 99%

Sensitivity and specificity of traditional testing methods to detect sensory impairment in the skin lesions of leprosy compared to Semmes–Weinstein monofilaments

Anitha¹,

Safar²,

Sasidharanpillai³

et al. 2020

LEPROSY

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To determine the sensitivity and specificity of traditional testing methods to detect sensory deficit in the skin lesions of leprosy in comparison to Semmes Weinstein (SW) nylon monofilaments. Design: After ethical clearance and written informed consent from study subjects, a consecutive series of 50 patients aged >12 years with leprosy skin lesions, who attended our institution, were evaluated in this cross sectional study. Results: 74 skin lesions of 50 patients were evaluated. Considering the monofilament test result as the gold standard, the sensitivity to detect sensory impairment was 95.9% for the ballpoint pen, 97.3% for a sterile needle and 100% for cotton wool, and cold and warm water. Limitation: Paucity of cases in the lepromatous spectrum of disease and the probable absence of early lesions of disease in the study group were the study limitations. Conclusions: The cotton wool and ballpoint pen methods are easy to perform in the field and have comparable sensitivity and specificity to the blue Semmes

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Comparative study of the cutaneous sensation of leprosy-suspected lesions using Semmes–Weinstein monofilaments and quantitative thermal testing

Cited by 27 publications

References 20 publications

Semmes-Weinstein monofilament: A tool to quantify skin sensation in macular lesions for leprosy diagnosis

Semmes-Weinstein monofilament: A tool to quantify skin sensation in macular lesions for leprosy diagnosis

Whole Mitogenome Sequencing Uncovers a Relation Between Mitochondrial Heteroplasmy and Leprosy Severity

Sensitivity and specificity of traditional testing methods to detect sensory impairment in the skin lesions of leprosy compared to Semmes–Weinstein monofilaments

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