Leprosy on the scalp

Macedo, Raila de Brito; Santos, Tárcio; Ramos, Paulyane Bezerra Sampaio; Takano, Daniela Mayumi; Leal, Virgínia Sampaio Madeiro

doi:10.1590/abd1806-4841.20164391

Cited by 7 publications

(7 citation statements)

References 5 publications

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“…Mycobacterium leprae prefers colder areas of the human body, 1 a direct implication of which is the development of “ Immune zones ” in leprosy—the scalp, axillae, genitalia, groin, eyelids, transverse band of skin overlying lumbosacral area, and the perineum. Most studies on leprosy with scalp involvement as well as mild and moderate infiltration showed no impairment of the vital part of the follicle as the deeper areas are not affected 2–4 . In our patient, however, there was a significant destruction of the hair follicles leading to patchy cicatricial alopecia.…”

Section: Discussioncontrasting

confidence: 43%

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Annular plaque over the scalp with patchy alopecia

et al. 2022

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Section: Discussioncontrasting

confidence: 43%

“…There have been less than 10 reports of paucibacillary leprosy involving the scalp, out of which three also had patchy alopecia 2–4 . Alopecia can be a presentation of leprosy and should be considered as a differential in endemic areas with such unusual presentations.…”

Section: Discussionmentioning

confidence: 98%

Annular plaque over the scalp with patchy alopecia

et al. 2022

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“…This may be due to the regrowth of hair in affected sites following leprosy treatment. 20 The finding of decreased hair on dermoscopy, in association with structureless areas is considered a specific finding that can differentiate leprosy from other granulomatous diseases. [9][10][11] During treatment, the number of dermal granulomas on histopathology may decrease, however, dermoscopic findings of structureless areas and globules were not found to be significantly associated with treatment duration.…”

Section: Discussionmentioning

confidence: 99%

Dermoscopic Patterns in Relation to the Clinicopathologic Manifestations of Leprosy

Gervasio¹,

Obbus²,

Camaclang-Balmores³

et al. 2021

Acta Med Philipp

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Objectives. Leprosy is a chronic granulomatous infection caused by the obligate intracellular organism Mycobacterium leprae. Current diagnostic tests for confirmation and treatment monitoring such as slit skin smear and biopsy are invasive and require time for processing, reading, and interpretation. Dermoscopy is a technique that allows the visualization of structures not readily seen by the naked eye. It can be performed at the point of care, providing a non-invasive link between clinical and histopathologic examination. This study aimed to determine the dermoscopic findings and associated clinicopathologic findings of the different forms of leprosy. Methods. A cross-sectional study was conducted. All new and follow-up patients aged 19 years old and above clinically diagnosed with leprosy were invited to participate in the study during the three-month investigation period. Clinical and dermoscopic photographs of representative skin lesions were taken, and a review of slit skin smear and histopathology results was done. Data analysis was performed using Stata SE version 13. The association between dermoscopic findings and the following parameters: anatomic location, Ridley-Jopling classification, WHO classification, treatment duration, and average bacteriologic index were analyzed using Fisher’s exact test. The level of significance was set at 5%. Results. A total of 57 lesions were included. Linear vessels (p=0.031), structureless areas (p=0.008), and globules (p=0.002) were found to be significantly associated with the anatomic location. Decreased hair was found to be significantly associated with treatment duration (p=0.038). No significant associations were found between dermoscopic findings and Ridley-Jopling classification, WHO classification, and ABI. Eight biopsies taken at the time of dermoscopy were reviewed, with all sites showing structureless or globular areas corresponding to the presence of granulomas on histopathology (100%). No other notable associations were observed. Conclusion. Dermoscopy is a potentially useful tool to aid in the diagnosis and treatment monitoring of leprosy. Limitations of this study include the small sample size, the preponderance of subjects in the lepromatous pole, and assessments by a single trained dermoscopist. A longer study duration including a larger number of newly diagnosed leprosy patients is recommended.

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“… 1 It can also present ocular, articular, ganglion, visceral, and bone marrow involvement. 2 , 3 Leprosy still represents an important public health problem, especially due to the stigmatizing sequelae and deformities. It is considered a neglected disease, strongly associated with unfavorable socioeconomic conditions.…”

Section: Introductionmentioning

confidence: 99%

Reviewing the therapeutic management of leprosy in primary care: demand case series referred to a University Hospital in the Midwest region of Brazil

Sousa¹,

Sousa²,

Turchi³

2021

Anais Brasileiros de Dermatologia

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Background Leprosy still represents a negleted public health problem in Brazil. Early and adequate treatment of leprosy, carried out in a primary health network is essential to reduce morbidity and sequelae. Objective To analyze the therapeutic management of leprosy patients referred from primary healthy services to a specialized service. Methods An analytical retrospective study using medical records and the Notifiable Diseases Information System. Patients diagnosed with leprosy, referred to a specialized outpatient clinic, between 2016 and 2017, in Goiás state, were included. The treatment carried out in the primary health services was compared to the Ministry of Health guidelines. Results Two-hundred twenty-five leprosy patients were included, of whom 33.3% were referred by leprosy reactions, 27.1% by sequelae, and 10.2% by suspected recurrence or reinfection. Reviewing the therapeutic management, 123 (54.7%) were considered inadequate, 92 (40.9%) adequate, and 10 (4.4%) inconclusive. Of the 200 multibacillary patients, 39.5% had adequate management. In contrast, 12 (85.1%) out of 14 paucibacillary patients had adequate management (χ 2 = 11.43 and p < 0.001). Regarding the leprosy reactions and sequelae management, 56.9% and 19.5% were considered inadequate, respectively. There was no difference between the percentage of adequate or inadequate management when considering the Goiás health macroregions (χ 2 = 7.23; 4 degrees of freedom; p = 0.12). Study limitations Use of recorded data, with incomplete medical records and lack of patient follow-up. Conclusions The study demonstrated the equivocal multibacillaryleprosy management conducted in healthy primary care, with an emphasis on leprosy reactions and sequelae. Training and monitoring the medical staff in the primary healthy services could reduce the morbidity and sequelae of leprosy.

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Leprosy on the scalp

Cited by 7 publications

References 5 publications

Annular plaque over the scalp with patchy alopecia

Annular plaque over the scalp with patchy alopecia

Dermoscopic Patterns in Relation to the Clinicopathologic Manifestations of Leprosy

Reviewing the therapeutic management of leprosy in primary care: demand case series referred to a University Hospital in the Midwest region of Brazil

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