Comparison of two systems of classification of leprosy based on number of skin lesions and number of body areas involved - A clinicopathological concordance study

Rao, P Narasimha; Suneetha, Sujai; Srinivas, D.; Lakshmi, T. S. S.

doi:10.4103/0378-6323.13779

Cited by 11 publications

(8 citation statements)

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“…19 The commonest histological type in a study by Sharma et al and Rao et al was borderline tuberculoid leprosy and that by Pandya et al was indeterminate leprosy. 6,8,27 In our study, there was complete agreement between the clinical and histopathological diagnosis in 39.58% of the cases. Similar comparative studies by different authors showed complete agreement between clinical and histopathological diagnosis which ranged from 31.58% to 82%.…”

Section: Discussionmentioning

confidence: 67%

Clinicohistopathological correlation of leprosy

2017

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BACKGROUND: Leprosy is a chronic infectious granulomatous disease caused by Mycobacterium leprae. It is a spectral disease which is classified into five groups according to Ridley and Jopling based on clinical, histological, microbiological and immunological criteria. Adequate clinical information combined with bacilloscopy and histopathology is helpful not only in classification of different types of leprosy but also useful for management of the cases.METHOD: 50 cases of leprosy were examined and clinical data was recorded. Slit skin smears were stained with Ziehl Neelsen stain. Skin biopsy was stained with Hematoxylin-Eosin stain and Fite Farraco stain was performed to demonstrate acid fast bacilli. All patients were classified according to Ridley & Jopling classification. Clinico-histopathological correlation was done. Statistical analysis was done using SPSS (Statistical Package for the Social Sciences) 16.0.RESULTS: Most common histological type of leprosy was tuberculoid leprosy seen in 19(38%) cases followed by indeterminate leprosy. Overall clinico-histopathological correlation was seen in 39.58%. The correlation was highest in indeterminate and histoid leprosy (100%) followed by lepromatous leprosy (66.66 %%) and tuberculoid leprosy (50%). Slit skin smear showed bacilli in 12 out of 48 cases (25%) while biopsy showed bacilli in 16 out of 48 cases (33.3%).CONCLUSION: In the present study, clinical diagnosis did not correlate with histopathological diagnosis significantly (p value=0.04159). The study emphasizes the role of histopathological and bacilloscopic examination to aid the clinical diagnosis for accurate typing of leprosy cases then better management of the patient.

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Section: Discussionmentioning

confidence: 67%

Clinicohistopathological correlation of leprosy

2017

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“…1 It affects primarily the peripheral nervous system and secondarily the skin. It can lead to deformities, sometimes irreversible, if not treated in time.…”

Section: Introductionmentioning

confidence: 99%

Quality of life of patients with paucibacillary leprosy

Bottene

Reis

2012

An. Bras. Dermatol.

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BACKGROUND -Leprosy, an infectious disease caused by Mycobacterium leprae, can affect the skin and the peripheral nervous system and, depending on the level of involvement, it can lead to severe deformities. Leprosy is classified into two major groups: paucibacillary (up to five lesions) and multibacillary (more than five lesions). The deformities that appear during the progress of the disease can affect the quality of life. OBJECTIVE -To assess quality of life of patients with paucibacillary leprosy diagnosed and treated early in the outpatients´ clinic. METHODS -The Dermatology Life Quality Index questionnaire and ShortForm36 were applied to 49 outpatients undergoing treatment at the Leprosy Multidisciplinary Group of the Hospital das Clínicas of the Faculdade de Medicina of the Universidade de São Paulo. RESULTS -The majority of the patients (63%) did not show impairment of the quality of life, according to the results obtained by the Dermatology Life Quality Index questionnaire. In the questionnaire Short Form-36, the scores assessed showed slight impairment of the quality of life. CONCLUSION -On this study, we can conclude that this group of patients, with paucibacillary leprosy, did not show important impairment of the quality of life. Therefore we can conclude that the earlier the diagnosis and the treatment the lesser the influence on the quality of life. Keywords: Dermatology; Leprosy; Quality of life; Questionnaires Resumo: Fundamentos -A hanseníase, doença infecciosa causada pelo Mycobacterium leprae, pode acometer a pele e o sistema nervoso periférico e de acordo com o grau de acometimento, levar a graves deformidades. É classificada em dois grandes grupos: paucibacilar (até cinco lesões) e multibacilar (mais de cinco lesões). As deformidades que podem ocorrer durante a evolução da doença levam ao comprometimento da qualidade de vida. OBJETIVO -Avaliar a qualidade de vida nos pacientes com hanseníase, do grupo paucibacilar, diagnosticados e tratados precocemente e em tratamento ambulatorial. MÉTODOS -Aplicação dos questionários Dermatology Life Quality Index e Short Form-36 a 49 doentes em tratamento no Ambulatório do Grupo Multidisciplinar de Hanseníase do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. RESULTADOS -A maioria (63%) dos 49 doentes, não apresentou comprometimento da qualidade de vida, na aplicação do questionário Dermatology Life Quality Index. Quanto ao questionário genérico Short Form-36, os escores alcança-dos demonstraram pouco comprometimento da qualidade de vida. CONCLUSÃO -O grupo de pacientes estudados com hanseníase paucibacilar mostrou pouco comprometimento da qualidade de vida levando-se em consideração os resultados obtidos nos dois questionários aplicados. Isto nos leva a concluir que quanto mais precoce é o diagnóstico e o tratamento, menor é o acometimento da qualidade de vida.

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“…Unless promptly and adequately treated, it can result in deformity and disability. Three types of reactions recognized are classified as: (1) type 1 reaction (T1R), (2) type 2 reaction (T2R) or erythema nodosum leprosum (ENL), and (3) the Lucio phenomenon [28]. Type 1 LR (T1R) and type 2 LR (T2R) are the main causes of nerve damage and permanent disability.…”

Section: Leprosy Reactionsmentioning

confidence: 99%

“…They may have aches and pains in the extremities and loss of strength and/or sensory perception. Sign manifestations increased inflammation become erythematous swollen and may be tender looking like erysipelas, edema of extremities or face frequently accompanied by nerve involvement, rapid swelling with severe pain/tenderness (neuritis), and sometimes loss of nerve function [28].…”

Section: Type 1 Reactionmentioning

confidence: 99%

“…Fever, joint pain and constitutional sign and symptom, and skin lesion appear together. T2R without ENL is possible that the manifestations of the reactions may not be confined to the skin, and the patients may develop neuritis or systemic involvement or both, depending upon the target organs where immune complexes deposition occurs [28].…”

Section: Current Topics In Tropical Emerging Diseases and Travel Medimentioning

confidence: 99%

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Leprosy: The Ancient and Stubborn Disease

Mawardi¹

2018

Current Topics in Tropical Emerging Diseases and Travel Medicine

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Leprosy can be caused by an infection of Mycobacterium leprae commonly acquired through contact with an infected person. Clinical presentation depends on the patient's immune status at the time of infection and during the course of disease. Leprosy is associated with disability and marginalization. The Global Leprosy Strategy 2016-2020 released in April 2016 underscored its goal of "accelerating towards a leprosy free-world." Today's leprosy differs from the leprosy of the past, but yet there are still many things that are not immediately known, so it is still a broad socioeconomic challenge for scientists to solve. Leprosy has low pathogenicity, only a small proportion of infected people develop signs of the disease. If leprosy is not diagnosed and treated in the early stages, further progress of the disease is determined by the strength of the patient's immune response. Various clinical signs can be known during the early phase of leprosy, defined as indeterminate phase, so that it is difficult to diagnose the disease. Multidrug therapy (MDT) was recommended as the standard treatment. The morbidity report of leprosy will be important in epidemiology because it is based on real events and not based on estimate.

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Comparison of two systems of classification of leprosy based on number of skin lesions and number of body areas involved - A clinicopathological concordance study

Cited by 11 publications

References 4 publications

Clinicohistopathological correlation of leprosy

Clinicohistopathological correlation of leprosy

Quality of life of patients with paucibacillary leprosy

Leprosy: The Ancient and Stubborn Disease

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