Leprosy is a chronic granulomatous disease. It involves the psychological, socioeconomic dimensions of an individual. Histopathology is considered as an accurate method for diagnosing leprosy. Immunity is largely T-cell mediated, whereas deficiency of T-cells causes lepromatous leprosy. The relative proportion of T and B lymphocytes were studied using CD3 and CD20 immunohistochemistry markers (IHC). A Retrospective, prospective and observational study was carried from August 2016 to July 2019. The cases were divided based on histopathological findings. IHC markers CD3 was used to study T cell whereas CD20 was used to study B-cells. As per Ridley Jopling classification maximum cases belonged to indeterminate forms. Bacillary load of 4+ and above was seen in lepromatous leprosy. CD3 showed strong positivity in all types whereas CD20 showed more focal positive staining for lepromatous leprosy than tuberculoid and indeterminate forms.
Subacute sclerosing panencephalitis (SSPE) is a chronic debilitating condition that occurs in children affected with measles. SSPE is broadly distinguished as typical SSPE, the more rampant form, occurring over a period of years following primary measles infection, while the atypical has a more rapidly progressive course over weeks to months. SSPE can present with cognitive, epileptic, autonomic, pyramidal and ophthalmologic manifestations with scholastic decline being the primary feature. The management of SSPE focuses on improvement of quality of life and prolongation of survival which can be achieved with the use of supportive care modalities and immunomodulators respectively. This is a comprehensive review which discusses several parameters of SSPE such as epidemiology, pathophysiology, clinical presentations, and detailed management protocol for this condition. As part of this review, we also discuss a case of rapidly progressive, fulminant and atypical SSPE in a five-year-old male presenting clinically with myoclonic jerks of lower extremities.
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