Bacillary and phagolysosomal changes in skin lesions of multidrug-treated borderline or lepromatous leprosy patients

1989 ◽  
Vol 27 (2) ◽  
pp. 196-197
Author(s):  
J. Boddingius ◽  
H.B.P.M. Dijkman ◽  
E.G. Hendriksen ◽  
E.P. Prens ◽  
J. Muntendam ◽  
...  
Keyword(s):  
Skin Lesions ◽  
Lepromatous Leprosy ◽  
Leprosy Patients

scholarly journals Characterization of MicroRNA Expression Profiles and Identification of Potential Biomarkers in Leprosy

2017 ◽  
Vol 55 (5) ◽  
pp. 1516-1525 ◽  
Author(s):  
Karina T. O. S. Jorge ◽  
Renan P. Souza ◽  
Marieta T. A. Assis ◽  
Marcelo G. Araújo ◽  
Massimo Locati ◽  
...  
Keyword(s):  
Expression Profiles ◽  
Principal Component ◽  
Skin Lesions ◽  
Lepromatous Leprosy ◽  
Diagnostic Potential ◽  
Reverse Transcription Quantitative Pcr ◽  
Leprosy Patients ◽  
Healthy Control ◽  
Validation Experiments

ABSTRACT Leprosy is an important cause of disability in the developing world. Early diagnosis is essential to allow for cure and to interrupt transmission of this infection. MicroRNAs (miRNAs) are important factors for host-pathogen interaction and they have been identified as biomarkers for various infectious diseases. The expression profile of 377 microRNAs were analyzed by TaqMan low-density array (TLDA) in skin lesions of tuberculoid and lepromatous leprosy patients as well as skin specimens from healthy controls. In a second step, 16 microRNAs were selected for validation experiments with reverse transcription-quantitative PCR (qRT-PCR) in skin samples from new individuals. Principal-component analysis followed by logistic regression model and receiver operating characteristic (ROC) curve analyses were performed to evaluate the diagnostic potential of selected miRNAs. Four patterns of differential expression were identified in the TLDA experiment, suggesting a diagnostic potential of miRNAs in leprosy. After validation experiments, a combination of four miRNAs (miR-101, miR-196b, miR-27b, and miR-29c) was revealed as able to discriminate between healthy control and leprosy patients with 80% sensitivity and 91% specificity. This set of miRNAs was also able to discriminate between lepromatous and tuberculoid patients with a sensitivity of 83% and 80% specificity. In this work, it was possible to identify a set of miRNAs with good diagnostic potential for leprosy.

scholarly journals Neutrophil NETworking in ENL: Potential as a Putative Biomarker: Future Insights

2021 ◽  
Vol 8 ◽  
Author(s):  
Smrity Sahu ◽  
Keshav Sharma ◽  
Maryada Sharma ◽  
Tarun Narang ◽  
Sunil Dogra ◽  
...  
Keyword(s):  
Biomarker Discovery ◽  
Point Of Care ◽  
Unmet Need ◽  
Skin Lesions ◽  
Immunosuppressive Drugs ◽  
Lepromatous Leprosy ◽  
Metabolic Reprogramming ◽  
Prolonged Treatment ◽  
Erythema Nodosum Leprosum ◽  
Leprosy Patients

Erythema nodosum leprosum (ENL), also known as type 2 reaction (T2R) is an immune complex mediated (type III hypersensitivity) reactional state encountered in patients with borderline lepromatous and lepromatous leprosy (BL and LL) either before, during, or after the institution of anti-leprosy treatment (ALT). The consequences of ENL may be serious, leading to permanent nerve damage and deformities, constituting a major cause of leprosy-related morbidity. The incidence of ENL is increasing with the increasing number of multibacillary cases. Although the diagnosis of ENL is not difficult to make for physicians involved in the care of leprosy patients, its management continues to be a most challenging aspect of the leprosy eradication program: the chronic and recurrent painful skin lesions, neuritis, and organ involvement necessitates prolonged treatment with prednisolone, thalidomide, and anti-inflammatory and immunosuppressive drugs, which further adds to the existing morbidity. In addition, the use of immunosuppressants like methotrexate, azathioprine, cyclosporine, or biologics carries a risk of reactivation of persisters (Mycobacterium leprae), apart from their own end-organ toxicities. Most ENL therapeutic guidelines are primarily designed for acute episodes and there is scarcity of literature on management of patients with chronic and recurrent ENL. It is difficult to predict which patients will develop chronic or recurrent ENL and plan the treatment accordingly. We need simple point-of-care or ELISA-based tests from blood or skin biopsy samples, which can help us in identifying patients who are likely to require prolonged treatment and also inform us about the prognosis of reactions so that appropriate therapy may be started and continued for better ENL control in such patients. There is a significant unmet need for research for better understanding the immunopathogenesis of, and biomarkers for, ENL to improve clinical stratification and therapeutics. In this review we will discuss the potential of neutrophils (polymorphonuclear granulocytes) as putative diagnostic and prognostic biomarkers by virtue of their universal abundance in human blood, functional versatility, phenotypic heterogeneity, metabolic plasticity, differential hierarchical cytoplasmic granule mobilization, and their ability to form NETs (neutrophil extracellular traps). We will touch upon the various aspects of neutrophil biology relevant to ENL pathophysiology in a step-wise manner. We also hypothesize about an element of metabolic reprogramming of neutrophils by M. leprae that could be investigated and exploited for biomarker discovery. In the end, a potential role for neutrophil derived exosomes as a novel biomarker for ENL will also be explored.

Unusual non-trophic ulcerations in leprosy: A case series of 17 patients

2021 ◽  
pp. 004947552199849
Author(s):  
Prakriti Shukla ◽  
Kiran Preet Malhotra ◽  
Parul Verma ◽  
Swastika Suvirya ◽  
Abir Saraswat ◽  
...  
Keyword(s):  
Erythema Nodosum ◽  
Case Series ◽  
Lepromatous Leprosy ◽  
Sweet Syndrome ◽  
Erythema Nodosum Leprosum ◽  
Leprosy Patients ◽  
Atypical Presentations ◽  
Neuropathic Ulcers

Non-neuropathic ulcers in leprosy patients are infrequently seen, and atypical presentations are prone to misdiagnosis. We evaluated diagnosed cases of leprosy between January 2017 and January 2020 for the presence of cutaneous ulceration, Ridley–Jopling subtype of leprosy, reactions and histologic features of these ulcerations. Treatment was given as WHO recommended multi-bacillary multi-drug therapy. We found 17/386 leprosy patients with non-neuropathic ulcers. We describe three causes – spontaneous cutaneous ulceration in lepromatous leprosy (one nodular and one diffuse), lepra reactions (five patients with type 1; nine with type 2, further categorised into ulcerated Sweet syndrome-like who also had pseudoepitheliomatous hyperplasia, pustulo-necrotic and necrotic erythema nodosum leprosum) and Lucio phenomenon (one patient). Our series draws attention towards the different faces of non-neuropathic ulcers in leprosy, including some atypical and novel presentations.

HLA-DQ molecules and the control ofMycobacterium leprae-specific T cell nonresponsiveness in lepromatous leprosy patients

1990 ◽  
Vol 20 (10) ◽  
pp. 2347-2350 ◽  
Author(s):  
Tom H. M. Ottenhoff ◽  
Charlotte Walford ◽  
Yasuharu Nishimura ◽  
N. B. B. Reddy ◽  
Takehiko Sasazuki
Keyword(s):  
T Cell ◽  
Lepromatous Leprosy ◽  
Hla Dq ◽  
Leprosy Patients

scholarly journals Risk factors for physical disability in patients with leprosy disease in Yunnan, China: Evidence from a retrospective observational study

2021 ◽  
Vol 15 (11) ◽  
pp. e0009923
Author(s):  
Xiaohua Chen ◽  
Hong-bing Liu ◽  
Tie-Jun Shui ◽  
Shun Zha
Keyword(s):  
Risk Factors ◽  
Physical Disability ◽  
Physical Disabilities ◽  
Delayed Diagnosis ◽  
Skin Lesions ◽  
Nerve Damage ◽  
Advanced Age ◽  
Han Ethnicity ◽  
Leprosy Patients ◽  
Male Sex

Background Leprosy is potentially debilitating. The risk factors related to physical disabilities associated with leprosy disease in Yunnan, China was not clear. Methodology/Principal findings We studied 10644 newly detected leprosy patients from Yunnan, China, from 1990 to 2019. Factors associated with Grade 1 (G1D) and Grade 2 (G2D) physical disabilities or overall physical disabilities (combined G1D and G2D) associated with leprosy were analyzed using multinomial and ordinal logistic regression analyses. The following factors were associated with the development of physical disability in these patients with leprosy: delayed diagnosis [odds ratio (OR): 5.652, 4.399, and 2.275; 95% confidence intervals (CIs): 4.516–7.073, 3.714–5.212, and 2.063–2.509; for ≥ 10, 5–10 y, and 2–5 years, respectively], nerve damage (OR: 3.474 and 2.428; 95% CI: 2.843–4.244, and 1.959–3.008; for 2 and 1 damaged nerves, respectively), WHO classification of PB (OR: 1.759; 95% CI: 1.341–2.307), Ridley-Jopling classification (OR: 1.479, 1.438, 1.522 and 1.239; 95% CI: 1.052–2.079, 1.075–1.923, 1.261–1.838, and 1.072–1.431; for TT, BT, BB, and BL when compared with LL, respectively), advanced age (OR: 1.472 and 2.053; 95% CI: 1.106–1.960 and 1.498–2.814; for 15–59 and over 60 years old, respectively), zero skin lesions (OR: 1.916; 95% CI: 1.522–2.413), leprosy reaction (OR: 1.528; 95% CI: 1.195–1.952), rural occupation (OR: 1.364; 95% CI: 1.128–1.650), Han ethnicity (OR: 1.268; 95% CI: 1.159–1.386), and male sex (OR: 1.128; 95% CI: 1.024–1.243). Conclusions Delayed diagnosis, nerve damage, no skin lesions, WHO and Ridley-Jopling classifications, leprosy reactions, advanced age, rural occupation, Han ethnicity, and male sex were associated with disability in leprosy patients. Identifying risk factors could help to prevent physical disability.

scholarly journals Significance of Histopathology in Leprosy Patients with 1–5 Skin Lesions with Relevance to Therapy

2011 ◽  
Vol 3 (01) ◽  
pp. 021-024 ◽  
Author(s):  
S Veena ◽  
Prakash Kumar ◽  
Shashikala P. ◽  
Gurubasavaraj H. ◽  
H R Chandrasekhar ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Skin Lesion ◽  
Skin Lesions ◽  
Clinicopathological Correlation ◽  
Adequate Treatment ◽  
Duration Of Therapy ◽  
Tuberculoid Leprosy ◽  
Leprosy Patients ◽  
Skin Biopsies ◽  
Severity Of The Disease

ABSTRACT Background: Patients with 1-5 skin lesions are clinically categorized as paucibacillary for treatment purposes. For betterment and adequate treatment of patients, this grouping needs further study. Aim: To study a group of leprosy patients with 1-5 skin lesions, compare clinical details with histopathological findings and bacteriological status of the skin to evaluate the relevance of this grouping. Materials and Methods: Two-year study involving 31 patients of leprosy with 1-5 skin lesions was included in this study. A number of skin lesions were recorded. Skin biopsies were taken in all patients. The biopsies were evaluated for the type of pathology and acid fast bacilli (AFB) status. Results: Of 31 patients, 19 (61.2%) had single skin lesion, 7 (22.5%) had two lesions, 4 (12.9%) had three lesions, and only one (3.22%) had four lesions, there were no patients with five lesions. Of the 31 patients, 30 (96.7%) were clinically diagnosed as borderline tuberculoid and one patient (3.22%) has tuberculoid leprosy. Skin smears were negative for AFB in all patients. The histological diagnoses were: TT 1 (3.22%), BT 24 (77.41%), and IL 6 (19.2%). AFB were found in 2 (6.45%) out of 31 skin biopsies. Clinicopathological correlation was 76.6% in the BT group. Conclusion: Tissue biopsy findings in 1-5 skin lesions which were not considered relevant for treatment purposes until now should be given a status in the categorization and assessment of severity of the disease. The significance of finding of AFB and histopathology of multibacillary (MB) type of leprosy in tissue biopsies, in patients grouped as PB should be resolved so that patients could be given the drug therapy and duration of therapy they warrant.

scholarly journals Powerful Bactericidal Activity of Moxifloxacin in Human Leprosy

2008 ◽  
Vol 52 (9) ◽  
pp. 3113-3117 ◽  
Author(s):  
Fe Eleanor F. Pardillo ◽  
Jasmin Burgos ◽  
Tranquilino T. Fajardo ◽  
Eduardo Dela Cruz ◽  
Rodolfo M. Abalos ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Side Effects ◽  
Bactericidal Activity ◽  
Mycobacterium Leprae ◽  
Skin Lesions ◽  
Definite Improvement ◽  
Highly Effective ◽  
Leprosy Patients ◽  
Multibacillary Leprosy

ABSTRACT In a clinical trial of moxifloxacin in eight multibacillary leprosy patients, moxifloxacin proved highly effective. In all trial patients, a single 400-mg dose of moxifloxacin resulted in significant killing (P ≤ 0.006) of Mycobacterium leprae, ranging from 82% to 99%, with a mean of 91%. In all instances, no viable bacilli were detected with an additional 3 weeks of daily therapy, this observed rapid bactericidal activity being matched previously only by rifampin. On moxifloxacin therapy, skin lesions cleared exceedingly rapidly with definite improvement observed consistently after eight doses and progressive resolution continuing for the 56 days of the trial. Side effects, toxicities, and laboratory abnormalities were mild, not requiring discontinuation of therapy.

Sign in / Sign up

Export Citation Format

Share Document