scholarly journals Significance of histopathology in the evaluation of paucibacillary leprosy

2021 ◽  
Vol 9 (2) ◽  
pp. 71-76
Author(s):  
Sindhushree N ◽  
Sindhu C ◽  
Sunita SV
Keyword(s):  
Informed Consent ◽  
Significant Role ◽  
Skin Lesions ◽  
Acid Fast Bacilli ◽  
Diagnostic Difficulty ◽  
Histopathological Evaluation ◽  
Tuberculoid Leprosy ◽  
Leprosy Patients ◽  
Skin Biopsies ◽  
Ethical Clearance

Background: Leprosy patients are classified into paucibacillary and multibacillary types on the basis of the number of skin lesions for the purpose of therapy. Patients with 1–5 skin lesions are clinically categorized as paucibacillary for treatment purposes. Aim: To study paucibacillary leprosy cases and compare clinical details with histopathological findings. Materials and methods: Three and half year study involving 130 patients of paucibacillary cases of leprosy diagnosed clinically and based on the 1–5 skin lesions was included in this study after ethical clearance and taking informed consent from patients. A number of skin lesions were recorded. Skin biopsies were taken in all patients. Biopsies were evaluated for the type of pathology and acid fast bacilli (AFB) status. Results: Of 130 patients, 81(62.3%) were males and 49(37.6%) were females. Majority of the clinically classified cases were borderline tuberculoid leprosy. The histological diagnoses were: TT 19(14.6%), BT 40(30.7%), IL 51(39.2%) and No evidence of leprosy 20(15.3%). AFB were found in 3(15.3%) out of 130 skin biopsies and all were borderline tuberculoid leprosy. Conclusion: Tissue diagnosis play a significant role in the diagnosis of leprosy. Early and borderline cases of leprosy poses a diagnostic difficulty to label only on clinical basis, so histopathological evaluation is must for confirming the diagnosis in doubtful cases of leprosy.

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.

Tzanck Smears and Its Diagnostic Utility - An Institutional Experience

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
Dr. Athulya Krishna Kumar K.T ◽  
Dr. Kalathingal Kamarunisha Aboobacker ◽  
Dr.Kiran H.S ◽  
Dr. Vishal Agarwal
Keyword(s):  
Skin Biopsy ◽  
Retrospective Analysis ◽  
Skin Lesions ◽  
Histopathological Diagnosis ◽  
Diagnostic Utility ◽  
Simple Test ◽  
Time Period ◽  
Histopathological Evaluation ◽  
Institutional Experience ◽  
Skin Biopsies

Aim: Tzanck smear is a simple test that gives reliable information in many varieties of skin lesions and can be used for quick, preliminary diagnosis of a number of cutaneous dermatoses. The aim of this study was to analyse the usefulness of tzanck smears in the diagnosis of cutaneous dermatoses and correlate the findings, clinically as well as histopathologically. Materials and Methods: Retrospective analysis of all tzanck smears received during the time period of 2 years (January 2016- January 2018), was carried out. The smears were assessed with regard to its correlation to the clinical diagnosis. Corroboration of the tzanck smear findings were also evaluated with respect to the histopathological diagnosis, in cases were skin biopsy was done. Results: A total of 70 tzanck smears were performed during our study period. Out of 29 cases of pemphigus, the tzanck smears corroborated with 22 cases. Non-specific findings were obtained in clinically suspected cases of pemphigoid. Out of 25 suspected herpetic infections, the characteristic tzanck smear findings were observed in 11 of them. Tzanck smear findings correlated with 13 out of the 19 cases of histopathologically confirmed pemphigus lesions. Conclusion: Tzanck smear test is a rapid, inexpensive and useful tool to aid in the diagnosis of clinically suspected vesico bullous, pustular and erosive skin lesions. It also serves as a useful adjunct to histopathological evaluation of skin biopsies, especially immuno-bullous skin disorders.

scholarly journals Quantitative PCR for leprosy diagnosis and monitoring in household contacts: A follow-up study, 2011–2018

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Fernanda S. N. Manta ◽  
Raquel R. Barbieri ◽  
Suelen J. M. Moreira ◽  
Paulo T. S. Santos ◽  
José A. C. Nery ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Skin Diseases ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Skin Lesions ◽  
Contact Tracing ◽  
Household Contacts ◽  
Leprosy Patients ◽  
Skin Biopsies

Abstract Household contacts (HHC) of leprosy patients exhibit high-risk of developing leprosy and contact tracing is helpful for early diagnosis. From 2011 to 2018,2,437 HHC were examined in a clinic in Rio de Janeiro, Brazil and 16S qPCR was used for diagnosis and monitoring of contacts. Fifty-four HHCs were clinically diagnosed with leprosy at intake. Another 25 exhibited leprosy-like skin lesions at intake, 8 of which were confirmed as having leprosy (50% of which were qPCR positive) and 17 of which were diagnosed with other skin diseases (6% qPCR positive). In skin biopsies, qPCR presented a sensitivity of 0.50 and specificity of 0.94. Furthermore, 955 healthy HHCs were followed-up for at least 3 years and skin scrapings were collected from earlobes for qPCR detection. Positive qPCR indicated a non-significant relative risk of 2.52 of developing the disease. During follow-up, those who progressed towards leprosy exhibited 20% qPCR positivity, compared to 9% of those who remained healthy. Disease-free survival rates indicated that age had a significant impact on disease progression, where patients over 60 had a greater chance of developing leprosy [HR = 32.4 (3.6–290.3)]. Contact tracing combined with qPCR may assist in early diagnosis and age is a risk factor for leprosy progression.

Recent Advancement in the Diagnosis and Treatment of Leprosy

2018 ◽  
Vol 18 (18) ◽  
pp. 1550-1558
Author(s):  
Muhammad Aamir ◽  
Asma Sadaf ◽  
Sehroon Khan ◽  
Shagufta Perveen ◽  
Afsar Khan
Keyword(s):  
Vitamin D ◽  
Drug Treatment ◽  
Mycobacterium Leprae ◽  
Neglected Diseases ◽  
Specific Drug ◽  
Genetic Studies ◽  
Vitamin D Receptors ◽  
Micro Rnas ◽  
Leprosy Patients ◽  
Skin Biopsies

Background: Many of the tropical diseases are neglected by the researchers and medicinal companies due to lack of profit and other interests. The Drugs for Neglected Diseases initiative (DNDi) is established to overcome the problems associated with these neglected diseases. According to a report published by the WHO, leprosy (Hansen's disease) is also a neglected infectious disease. Methods: A negligible amount of advancements has been made in last few decades which includes the tools of diagnosis, causes, treatment, and genetic studies of the bacterium (Mycobacterium leprae) that causes leprosy. The diagnosis of leprosy at earlier stages is important for its effective treatment. Recent studies on vitamin D and its receptors make leprosy diagnosis easier at earlier stages. Skin biopsies and qPCR are the other tools to identify the disease at its initial stages. Results: Until now a specific drug for the treatment of leprosy is not available, therefore, Multi-Drug Therapy (MDT) is used, which is hazardous to health. Besides Mycobacterium leprae, recently a new bacterium Mycobacterium lepromatosis was also identified as a cause of leprosy. During the last few years the genetic studies of Mycobacterium leprae, the role of vitamin D and vitamin D receptors (VDR), and the skin biopsies made the treatment and diagnosis of leprosy easier at early stages. The studies of micro RNAs (miRNAs) made it easy to differentiate leprosy from other diseases especially from tuberculosis. Conclusion: Leprosy can be distinguished from sarcoidosis by quantitative study of reticulin fibers present in skin. The treatment used until now for leprosy is multi-drug treatment. The complete genome identification of Mycobacterium leprae makes the research easy to develop target specified drugs for leprosy. Rifampicin, identified as a potent drug, along with other drugs in uniform multi-drug treatment, has a significant effect when given to leprosy patients at initial stages. These are effective treatments but a specific drug for leprosy is still needed to be identified. The current review highlights the use of modern methods for the identification of leprosy at its earlier stages and the effective use of drugs alone as well as in combination.

Photosensitization Induced by Heterophyllaea pustulata in Goats: Sequential Development of Skin Lesions

2021 ◽  
Vol 58 (3) ◽  
pp. 568-573
Author(s):  
Juan F. Micheloud ◽  
Lluís Luján ◽  
Luis A. Colque-Caro ◽  
Susana C. Núñez-Montoya ◽  
Claudio G. Barbeito ◽  
...  
Keyword(s):  
Cell Death ◽  
Oral Dose ◽  
Skin Lesions ◽  
Crust Formation ◽  
Cutaneous Lesions ◽  
Protein Ratio ◽  
Dermal Fibrosis ◽  
Sequential Development ◽  
Treatment Changes ◽  
Skin Biopsies

Five adult Saanen goats received a single oral dose of Heterophyllaea pustulata containing 42.25 μg/kg rubiadin (anthraquinone) and 3 adult goats were untreated controls. All goats were exposed to sunlight and sequential ear skin biopsies were collected before treatment and at 32 hours, 3 days, 8 days, and 15 days after treatment. Changes at 32 hours after dosing included epidermal spongiosis, single cell death and acantholysis, an increased BAX/BCL-2 protein ratio, and dermal edema. Lesions at day 3 included epidermal and adnexal necrosis, crust formation, and acanthosis. Acanthosis, hyperkeratosis, and dermal fibrosis and neovascularization were present at day 15. The pro-apoptotic (BAX)/anti-apoptotic (BCL-2) protein ratio increased at 32 hours, whereas epidermal and dermal PCNA immunolabeling increased between days 8 and 15 after treatment. The cutaneous lesions were consistent with sunlight-induced damage, and the occurrence in treated but not control goats indicates photosensitization.

scholarly journals MCPIP1/Regnase-1 Expression in Keratinocytes of Patients with Hidradenitis Suppurativa: Preliminary Results

2021 ◽  
Vol 22 (14) ◽  
pp. 7241
Author(s):  
Piotr K. Krajewski ◽  
Weronika Szukała ◽  
Agata Lichawska-Cieślar ◽  
Łukasz Matusiak ◽  
Jolanta Jura ◽  
...  
Keyword(s):  
Western Blot ◽  
Mrna Expression ◽  
Hidradenitis Suppurativa ◽  
Skin Lesions ◽  
Healthy Controls ◽  
Lesional Skin ◽  
Chemotactic Protein ◽  
Healthy Control ◽  
Mrna And Protein Expression ◽  
Skin Biopsies

The pathogenesis of hidradenitis suppurativa (HS) is yet to be fully understood. However, inflammation is a key element in the development of skin lesions. The aim of this study was to evaluate the expression of monocyte chemotactic protein-1-induced protein-1 (MCPIP1) in the skin of patients suffering from HS. Skin biopsies of 15 patients with HS and 15 healthy controls were obtained and processed for immunohistochemistry, western blot, and real time PCR. The highest mean MCPIP1 mRNA expression was found in the inflammatory lesional skin of HS patients. It was significantly higher than MCPIP1 mRNA expression in the biopsies from both healthy controls and non-lesional skin of HS patients. Western blot analysis indicated that expression of MCPIP1 was elevated within both lesional and non-lesional skin compared to the healthy control. The increased MCPIP1 mRNA and protein expression level in HS lesions may indicate its possible role in the disease pathogenesis.

Histopathology of the soft parts in 50 patients with malignant external otitis

1989 ◽  
Vol 103 (4) ◽  
pp. 366-368 ◽  
Author(s):  
J. Bernheim ◽  
J. Sade
Keyword(s):  
Skin Lesions ◽  
External Otitis ◽  
Pathological Feature ◽  
External Ear ◽  
Ear Canal ◽  
Malignant External Otitis ◽  
External Ear Canal ◽  
External Canal ◽  
Skin Biopsies ◽  
Skin Coverage

AbstractReports concerning the lesions of the skin coverage of the external ear canal in malignant external otitis (M.E.O.) are very few. To evaluate this problem, we studied the skin lesions of 45 skin biopsies from 40 M.E.O. patients, 23 from regions covering the osseous part of the ear structure, seven from the cartilaginous part of the external canal and 15 from both parts. The epidermis was normal in nine, thickened in 16, with acanthotic thickening and pseudoepitheliomatous hyperplasia in 20. In the dermis the amount of collagen was normal, but it was infiltrated by the inflammatory process. Acute inflammation was observed in 16 biopsies, subacute in 23, chronic in six. A mixture of acute and chronic changes was present in 18 biopsies. No major abnormalities of the vasculature could be detected. The distinguishing pathological feature of M.E.O. concerns the typical topographic distribution of the inflammation in the osseous part of the external ear canal.

NONTUBERCULOUS ACID-FAST BACILLI IN CERVICAL ADENITIS

PEDIATRICS ◽  
1957 ◽  
Vol 20 (4) ◽  
pp. 688-697
Author(s):  
Haddow M. Keith ◽  
Lyle A. Weed ◽  
Gerald M. Needham
Keyword(s):  
Giant Cells ◽  
Skin Lesions ◽  
Mycobacterium Ulcerans ◽  
Cervical Region ◽  
Tubercle Bacillus ◽  
Cervical Lymph Nodes ◽  
Caseous Necrosis ◽  
Acid Fast Bacilli ◽  
Cervical Adenitis ◽  
Bona Fide

THE TUBERCLE bacillus is the most common cause of lymphadenitis with caseous necrosis. Such a condition in the cervical region, while less frequent than in previous decades, still occurs occasionally. While other agents, for example, Coccidioides, Histoplasma, Brucella, Pasteurella and Miyagawanella, are known to produce a similar histopathologic reaction, they are not commonly associated with lesions in the cervical lymph nodes, especially in children. Therefore the finding of acid-fast bacilli in such lesions has generally been considered bona fide evidence of tuberculosis, although previous reports from this clinic indicate that such is not necessarily true. It is recognized that there are other acid-fast bacilli, such as the lepra and smegma bacilli, which may or may not cause disease. In 1944 Gellerstedt reported seven cases of tuberculoid skin lesions due to atypical acid-fast bacilli. He considered these to be due to exogenous infection with acid-fast bacilli differing from the organisms found in tuberculosis, and he considered them as possibly saprophytic organisms. In 1948 MacCallum and co-workers reported six cases of skin lesions due to acid-fast organisms that were not Mycobacterium tuberculosis. The lesions did not contain tubercle follicles, giant cells or caseous material. The name "Mycobacterium ulcerans" was applied to these organisms by Australian workers. In 1954 Linnell and Nordén described skin lesions that occurred in 80 boys and girls who used a certain swimming pool in a Swedish town. The etiologic organisms were acid fast, differed from those described by MacCallum and associates and were not lepra bacilli. Guinea pigs injected with these organisms presented no evidence of lesions after 7 weeks.

scholarly journals Pattern of mycobacterial antigen detection in leprosy

1995 ◽  
Vol 37 (1) ◽  
pp. 7-12 ◽  
Author(s):  
C. Pagliari ◽  
M. I. S. Duarte ◽  
M. N. Sotto
Keyword(s):  
Particulate Material ◽  
Antigen Detection ◽  
Mycobacterial Antigen ◽  
Material Characteristics ◽  
Leprosy Patients ◽  
Antigenic Material ◽  
Skin Biopsies

Immunohistochemistry reaction (Peroxidase anti-peroxidase - PAP) was carried out on fifty-two skin biopsies from leprosy patients with the purpose to identify the antigenic pattern in mycobacteria and to study the sensitivity of this method. Five different patterns were found: bacillar, granular, vesicular, cytoplasmatic and deposits, classified according to the antigenic material characteristics. Deposits (thinely particulate material) appeared more frequently, confirming the immunohistochemistry sensitivity to detect small amounts of antigens even when this material is not detected by histochemical stainings.

scholarly journals Clinico-bacterial correlation of bacterial index in Hansen’s disease

2016 ◽  
Vol 6 (12) ◽  
pp. 998-1000
Author(s):  
SM Jha ◽  
AKS Dangol ◽  
S Shakya ◽  
B Jha
Keyword(s):  
Clinical Manifestations ◽  
Clinical Information ◽  
Accurate Diagnosis ◽  
Cross Sectional ◽  
Hansen's Disease ◽  
Hansen’S Disease ◽  
Tuberculoid Leprosy ◽  
Classi Cation ◽  
Leprosy Patients ◽  
Bacterial Index

Background: Leprosy has a broad spectrum of clinical manifestations. Clinical information along with Bacterial evidence is necessary to achieve accurate diagnosis. The present study was carried out to nd out clinical and bacterial correlation in various presentations according to Ridley Jopling classi cation of Hansen’s Disease. Materials and Methods: It was a hospital based cross-sectional comparative study of 72 leprosy patients over a period of 1 year and it’s clinico-Bacterial correlation was done with the help of Slit Skin Smear and clinical classi cation. Results: This study included 72 leprosy patients at various stages according to Ridley Jopling classi cation. Maximum cases belonged to Borderline Tuberculoid leprosy 28(38.88%) followed by Tuberculoid leprosy 15(20.83%). Slit Skin Smear showed 12(42.85%) of Borderline Tuberculoid and 3(20%) of Tuberculoid cases had disparity and didn’t match corresponding clinical subtype. Conclusion: Clinical features along with Bacterial index is useful in making accurate diagnosis so that appropriate treatment could be started and hence deformity and disability could be prevented. 

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