Histopathology of skin lesions of leprosy before and after fixed duration treatment

Sasidharanpillai, Sarita; Govindan, Aparna; Riyaz, Najeeba; Binitha, Manikoth Payyanadan; Parambath, Sathi Puthen; Khader, Anza; Pavithran, Pabin; Sureshan, Deepthi N; Chandrasekhar, Nirmal; Haridas, Neethu

doi:10.47276/lr.88.1.142

Cited by 2 publications

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“…Previous authors have noted patients with indeterminate leprosy manifesting granulomas after completion of treatment. [ 10 11 ] The possible explanations put forth are the treatment-induced immune activation or an inability of MDT to alter the natural course of the disease in at least some of the patients. [ 10 ]…”

Section: Discussionmentioning

confidence: 99%

Hypopigmented skin lesions with doubtful/minimal sensory impairment: A histopathology-based analysis

Sasidharanpillai

Govindan

Dominic

et al. 2022

Indian Dermatol Online J

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Background: Cardinal criteria proposed by the World Health Organisation (WHO) lack sensitivity to diagnose indeterminate leprosy. Aims: To estimate the frequency of hypopigmented skin lesions with doubtful/minimal sensory impairment showing histopathology features of indeterminate leprosy. To compare between the histopathology findings noted in specimens showing features suggestive of indeterminate leprosy and those showing a non-specific dermatitis pattern. Materials and Methods: Data on patients who attended our department with hypopigmented patches with doubtful/minimal sensory impairment from January 2018 to December 2019 and who underwent a skin biopsy were collected. A pathologist blinded to the clinical findings reviewed the histopathology specimens using a pre-set questionnaire. Results: We studied sixteen biopsy specimens from 14 patients. Eight specimens (50%) showed histopathology suggestive of indeterminate leprosy and the remaining eight showed a non-specific dermatitis pattern. A higher percentage of patients with indeterminate pattern showed mast cells (87.5% vs 25%) and fibrosis around nerve twig or sweat duct (75% vs 12.5%) when compared to those who showed a non-specific dermatitis pattern. Limitations: Small sample size and retrospective study design were the limitations. Conclusions: We found histopathology features of indeterminate leprosy in 50% of the skin biopsy specimens from hypopigmented lesions with doubtful/minimal sensory impairment. The present study highlights the need to improve the diagnostic definition of indeterminate leprosy.

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Section: Discussionmentioning

confidence: 99%

Hypopigmented skin lesions with doubtful/minimal sensory impairment: A histopathology-based analysis

Sasidharanpillai

Govindan

Dominic

et al. 2022

Indian Dermatol Online J

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“…[10][11][12] In patients where lesions of different spectrum are present, biopsy must be obtained from the most downgraded lesion to obtain most clinically useful information. [13] Most biopsies of leprosy irrespective of the spectrum show the leprosy pattern which is characterised by superficial and deep discrete, perivascular, periappendageal and perineural inflammatory infiltrate in an oval, oblong or curvilinear configuration. [12] Histopathologic features can be extremely useful in classifying the type of leprosy and identification of the presence of a leprosy reaction.…”

Section: Histopathologymentioning

confidence: 99%

“…Lymphocyte infiltration usually involves perineural sheath with preservation of nerve parenchyma, but the nerve fibre could be completely replaced by lymphocytes occasionally. [13] Proliferation of Schwann cells results in loss of wavy pattern of nerves and loss of longitudinal orientation of individual Schwann cell nuclei resulting in 'baton'-shape of nuclei in normal nerves.…”

Section: Indeterminate Leprosymentioning

confidence: 99%

Diagnosis of Leprosy: Current Updates and Future Directions

Bathula

Khurana

Singh³

2023

IJPGD

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Leprosy is a chronic infectious granulomatous disorder caused by Mycobacterium leprae, chiefly affecting skin and peripheral nerves. It is the only known bacteria to infect nerves. Clinical diagnosis of leprosy is made when any of the three cardinal signs defined by the World Health Organisation is present. However, leprosy has varied presentations necessitating laboratory diagnostic methods for diagnosis as well as treatment initiation and monitoring. Slit-skin smears and histopathology form the basic diagnostics of maximum utility, while neurological studies, cytology and imaging have significant specific roles. Novel molecular and serological tests are of value in the diagnosis of early, indeterminate, and paucibacillary leprosy, and for screening of asymptomatic contacts. Molecular methods have in addition found an important place in diagnosis of drug resistance in leprosy.

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Histopathology of skin lesions of leprosy before and after fixed duration treatment

Cited by 2 publications

References 0 publications

Hypopigmented skin lesions with doubtful/minimal sensory impairment: A histopathology-based analysis

Hypopigmented skin lesions with doubtful/minimal sensory impairment: A histopathology-based analysis

Diagnosis of Leprosy: Current Updates and Future Directions

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