Repeatability of nerve thickness assessment in the clinical examination for leprosy

Kolappan, C; Selvaraj, Rajalakshmi; Khudoos, Abdul; Gowda, B. N. Appe; Datta, Manjula; Prabhakar, R

doi:10.5935/0305-7518.19950025

Cited by 7 publications

(5 citation statements)

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“…Depending upon the leprosy subtype, clinical manifestations include sensory deficit, nerve thickening, hypo-or hyperpigmentation, dry skin, erythema, papules, nodules, and ulceration [22][23][24] . Some of these abnormalities remain after leprosy is cured microbiologically [25][26][27] .…”

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confidence: 99%

Decreased Cutaneous Resonance Running Time in Cured Leprosy Subjects

Shu-min

Elias

et al. 2009

Skin Pharmacol Physiol

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Background/Objectives: Leprosy prominently involves both the skin and peripheral neural tissues and some symptoms persist after microbial cure. Because alterations in the dermis also occur in leprosy, we assessed here whether there were changes in cutaneous resonance running time (CRRT), a parameter that is influenced by collagen properties, in cured leprosy subjects. Methods: A reviscometer was used to measure the CRRT at various directions on the dorsal hand and the flexural forearms of 76 cured leprosy subjects aged 50–85 years and 68 age-matched normal subjects. Results: In comparison to normal subjects, CRRTs on the hands and the forearms were significantly reduced in all directions in cured leprosy, except at the 1–7, 2–8 and 3–9 o’clock directions on the forearms. CRRTs were reduced significantly at both the 4–10 and 5–11 o’clock directions on the forearm in lepromatous (73.33 ± 4.19 at 4–10 o’clock and 67.44 ± 2.71 at 5–11 o’clock direction) and borderline lepromatous types (77.58 ± 5.84 at 4–10 o’clock and 79.85 ± 6.81 at 5–11 o’clock direction) as compared with normal (143.10 ± 7.75 at 4–10 o’clock and 125.18 ± 8.14 at 5–11 o’clock direction). On the hand, CRRTs at all directions, except that at 4–10 o’clock direction, were also significantly reduced in lepromatous and borderline lepromatous types in comparison with normal. Significant differences in CRRT at some directions were found among the various subtypes of leprosy. Conclusion: CRRTs were abnormal in the cured leprosy subjects as a whole, but varied with leprosy subtypes, which suggested that the extent of reduction of CRRTs correlates with the severity of immune alteration. These results suggest that CRRT measurements could be a useful approach to quantify the extent of some residual abnormalities in cured leprosy and perhaps could also be used to evaluate the efficacy of treatment.

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confidence: 99%

Decreased Cutaneous Resonance Running Time in Cured Leprosy Subjects

Shu-min

Elias

et al. 2009

Skin Pharmacol Physiol

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“…Nerve palpation is 'subjective' but it has been shown that it can be done reliably for some nerves. 15,16 However, expertise in nerve palpation and interpretation of findings is usually only available with those routinely palpating nerves, which was the case in every research site.…”

Section: Discussionmentioning

confidence: 99%

Pure neural leprosy—mind the diagnosis

Brandsma¹,

Post²,

Wagenaar³

et al. 2021

LEPROSY

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Introduction: Pure Neural Leprosy (PNL) is a known clinical diagnosis of leprosy. There is great epidemiological variability in the diagnosis and there appears to be no consensus about its definition and classification. Given the reported prevalence it is for operational reasons important that there is consensus about its definition, classification and treatment. Method: The TENLEP (Treatment of early Neuropathy in LEProsy) database was used to analyze patients that were enrolled with a diagnosis of PNL to determine proportions of patients with PNL enrolled in six research sites in four geographically different leprosy endemic countries. Demographics were looked at and frequency of nerves involved in PNL. The database consists of data of 1240 patients that were enrolled to determine efficacy of prednisolone in the prevention of clinical neuropathy (N = 372) or the treatment of clinical neuropathy (N = 868).

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“…Thickened nerves were found in a greater proportions of new cases in Ethiopia (ulnar nerve in 68%), [6] where the patients often present late, than in India (ulnar nerve in 23%), [7] where detection is generally much earlier. Reported figures for nerve enlargement in MB and PB patients from Bangladesh are 96% and 86% respectively, [5] whereas in Ethiopia, the corresponding figures were 91% and 76%.…”

Section: Skin Lesions With Sensory Impairment Skin Lesions With Sensomentioning

confidence: 95%