scholarly journals A study of clinico pathological spectral correlation in multibacillary leprosy

2020 ◽  
Vol 6 (2) ◽  
pp. 218
Author(s):  
Anita Sanker ◽  
P. S. Mathew ◽  
G. Nandakumar ◽  
Sandhya George ◽  
V. G. Binesh
Keyword(s):  
Histopathological Examination ◽  
Lepromatous Leprosy ◽  
Newly Diagnosed ◽  
Spectral Correlation ◽  
Medical College ◽  
Additional Information ◽  
Histopathological Correlation ◽  
Leprosy Patients ◽  
Diagnosis And Classification ◽  
Multibacillary Leprosy

<p class="abstract"><strong>Background:</strong> Leprosy expresses itself in different clinico-pathological forms, depending on the immune status of the host.The diagnosis and classification of leprosy have traditionally been based on the clinical examination with additional information from skin smears and histopathological examination. Very often, disparities between clinical and histopathological findings are observed. This study was aimed to correlate between clinical and histopathological spectral correlation of newly diagnosed multibacillary leprosy cases for a period of 1 year.</p><p class="abstract"><strong>Methods:</strong> The study was conducted in the Department of Dermatology and Venereology, Government Medical College, Thiruvananthapuram, for a period of 1 year. All newly diagnosed multibacillary leprosy cases were included.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 40 patients with clinically diagnosed multi bacillary leprosy were studied. Maximum numbers of leprosy patients studied were in the age group of 40-49 years. Maximum clinical and histopathological correlation was found in 75% (9/12) in lepromatous leprosy and least correlation of 44.44% was noted in borderline lepromatous (4/9).</p><p class="abstract"><strong>Conclusions:</strong> In this study maximal clinico-histopathological spectral correlation was found in lepromatous  spectrum. The percentage of correlation was considerably less in all the other groups.</p>

HISTOPATHOLOGICAL EVALUATION OF WHO CLASSIFIED MULTIBACILLARY LEPROSY CASES IN A TERTIARY CARE CENTRE, SOUTH KERALA

2021 ◽  
pp. 32-34
Author(s):  
Anita Sanker ◽  
G Nandakumar ◽  
Swapna Balkrishnan
Keyword(s):  
Immune Response ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Newly Diagnosed ◽  
Epithelioid Cells ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Leprosy Patients ◽  
Epidermal Atrophy ◽  
Multibacillary Leprosy

There are signicant differences in the histopathology of leprosy lesions which is inuenced by the host immune response to Mycobacterium leprae. Objective - To nd the histopathological changes in newly diagnosed multibacillary leprosy(MB) cases registered in the skin department Government Medical College, Thiruvananthapuram. Method- skin biopsy performed in 40 multibacillary leprosy cases and histopathological ndings were evaluated. 70% showed epidermal atrophy. Granulomas, composed of sheets of foamy macro Results- phages, lymphocytes and epithelioid cells, were seen in 21 cases & twenty two cases were AFB positive. Eight cases each were lepromatous, borderline tuberculoid, mid boderline, borderline lepromatous types. Conclusion- Presence of 60% cases of borderline leprosy indicates the unstable immune response in leprosy patients. Majority were either borderline lepromatous or lepromatous showing the infective nature of multibacillary leprosy. Histopathological examination with Fite- Foroco staining is a crucial method and the gold standard for accurate diagnosis and typing of leprosy.

scholarly journals Spectrum of Leprosy Patients with Clinico-Histopathological Correlation: A Hospital Based Study

2013 ◽  
Vol 4 (4) ◽  
pp. 11-16
Author(s):  
Arjun Singh ◽  
R Gaur ◽  
R Ambey
Keyword(s):  
Histopathological Examination ◽  
Medical Science ◽  
Polar Group ◽  
Female Ratio ◽  
Histopathological Correlation ◽  
Leprosy Patients ◽  
Diagnosis And Classification ◽  
Skin Biopsies ◽  
Hematoxylin And Eosin ◽  
Minor Disagreement

Introduction: Leprosy is a chronic granulomatous, infectious disease involving skin and peripheral nerves. It is present in various clinicopathological forms depending upon immune status of the patients. Histopathological examination of skin provides confirmatory diagnosis in suspected cases and gives indication of progression and regression of disease under treatment. Ridley and Jopling classification is used to classify leprosy. The objective of study was to identify the clinical pattern of leprosy and performed detail clinico- histopathological correlation in our institute. Method: The study was carried out on the skin biopsies received in between 2007-2010. Biopsies were fixed in 10% formalin, processed and stained with Hematoxylin and Eosin, modified Fite Ferraco and Ziehl-Neelsen stains. The predesigned Performa was used to record observation. The clinical diagnosis were correlated with histopathology in all 120 cases. Result: The age of the patients was ranged from 8 to 79 years with mean age of 36.38 years. The male to female ratio of patients was 1.5 to 1. The majority of cases 79 (65.8%) were in the age group of 21-50 years. Highest parity was observed in stable polar group TT 100%. Clinco-histopathological agreement was seen in 98 (81.67%) cases, 14 (11.67%) cases shows minor disagreement and 8 (6%) cases major disagreement. Conclusion: The clinical and histopathological features along with bacteriological index are useful than any single parameter in arriving definitive diagnosis and classification of the leprosy. Asian Journal of Medical Science, Volume-4 (2013), Pages 11-16 DOI: http://dx.doi.org/10.3126/ajms.v4i4.7997 

scholarly journals Clinical variables associated with disability in leprosy cases in northeast Brazil

2015 ◽  
Vol 9 (03) ◽  
pp. 232-238 ◽  
Author(s):  
Victor Santana Santos ◽  
Andressa Mayara Santos de Matos ◽  
Lorena Sheila Alves de Oliveira ◽  
Ligia Mara Dolce de Lemos ◽  
Ricardo Queiroz Gurgel ◽  
...  
Keyword(s):  
Physical Disability ◽  
Lepromatous Leprosy ◽  
Northeast Brazil ◽  
Chi Square ◽  
Factors Associated ◽  
Operational Classification ◽  
Leprosy Patients ◽  
Chi Square Test ◽  
Multibacillary Leprosy ◽  
Significant Factors

Introduction: The clinical outcomes of leprosy include complications such as physical disabilities and deformities that vary according to the degree of impairment of nerve trunks. Knowledge of the factors that lead to the development of these complications is important for disability prevention programs. This study aimed to evaluate clinical factors associated with the occurrence of physical disability in leprosy cases. Methodology: This was a retrospective study of 2,358 cases of leprosy in Aracaju, northeast Brazil, between 2001 and 2011. Analysis was done using the Chi-square test and logistic regression model. Results: Significant factors associated with disability were found to be male gender, having more than two affected nerves, multibacillary leprosy classification, leprosy reaction, and lepromatous leprosy. The multivariate analysis revealed that the associated factors included having more than two affected nerves, leprosy reaction (adjusted odds ratio [aOR]: 2.02, 95% confidence interval [CI]: 1.36 to 3.01), the multibacillary form (aOR: 2.74, 95% CI: 1.84 to 4.08), and lepromatous leprosy (aOR: 4.87, 95% CI: 2.86 to 16.08). Conclusions: The number of affected nerves, leprosy reaction, operational classification, and clinical presentation were identified as the main factors associated with the development of disability in leprosy patients.

scholarly journals Clinical profile and deformities in leprosy patients: a record based study

2020 ◽  
Vol 6 (2) ◽  
pp. 156
Author(s):  
Anita Sanker ◽  
Sandhya George ◽  
Sindhu Chunangat Bhaskaramenon
Keyword(s):  
Public Health Problem ◽  
Mycobacterium Leprae ◽  
Clinical Profile ◽  
Current Status ◽  
Age Group ◽  
Medical College ◽  
Tribal Area ◽  
Leprosy Patients ◽  
Multibacillary Leprosy

<p class="abstract"><strong>Background:</strong> Leprosy is a chronic disease caused by <em>Mycobacterium leprae</em>, infectious in some cases, and affecting the peripheral nervous system, skin and certain other tissues. Even though leprosy was declared eliminated as a public health problem in India on December 2005, new cases of leprosy continue to appear. Hence a study on clinical profile and deformities in all leprosy cases registered in the last 5 years was done to know the current status of leprosy in this area.</p><p class="abstract"><strong>Methods: </strong>This was a retrospective record-based study of leprosy cases done at Government Medical College, Manjeri, for a period of 5 years from October 2014 to September 2019.<strong></strong></p><p class="abstract"><strong>Results:</strong> 42 cases from the record were included in the study. Maximum cases belonged to the age group of 31 to 40 and males were more than females. 81% of the patients were multibacillary leprosy (MB) and 8 cases belonged to paucibacillary (PB) leprosy. Four child cases were registered as PB cases. Mostly encountered clinical diagnosis was borderline tuberculoid leprosy (23 out of 42) and two had type 1 reaction. Seven patients had deformity of which two had grade 2 deformity and rest had grade 1 deformity.</p><p><strong>Conclusions:</strong> One patient who presented with grade 2 deformity and type 1 reaction was from tribal area indicating low awareness about leprosy among them. More number of cases in the multibacillary group and presence of child cases and deformities reinforces the need for strict surveillance to eradicate leprosy. </p>

scholarly journals Histomorphological Study of Leprosy with Clinical Correlation in Kumaon Region

2019 ◽  
Vol 6 (12) ◽  
pp. 4657-4663
Author(s):  
Neha Yadav ◽  
Binay Kumar ◽  
Usha Joshi ◽  
Mukesh Kumar ◽  
Saurabh Agarwal
Keyword(s):  
Histopathological Examination ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Lepromatous Leprosy ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Cross Sectional ◽  
Histopathological Correlation ◽  
Kappa Test ◽  
Bacterial Index

Background: Leprosy is a leading cause of permanent physical disability. Approx 60% of global burden of leprosy is represented by India. Histopathological examination is still considered gold standard for accurate categorization of leprosy so that timely treatment can be started. Objectives:  To categorize and correlate types of leprosy clinically and histomorphologically in Kumaon region. Methods: The present cross-sectional study of 62 cases was conducted in the Department of Pathology & Skin and V.D in a tertiary care centre of Kumaon region from August 2016 to April 2018. The cases were clinically examined and categorized according to Ridley-Jopling classification. Skin Biopsy and Slit-Skin Smear (SSS) were taken for accurate histomorphogical categorization of leprosy and assessment of bacterial index, followed by clinico-histomorphological correlation. Statistical analysis was done in term of chi-square test. Kappa test was used as agreement test for clinical versus histological classification of different type of leprosy. Results:  A total of 62 clinically diagnosed leprosy cases evaluated histopathologically. Clinically, lepromatous leprosy (LL) was the most common type of leprosy (38.70%), followed by borderline tuberculoid (30.64%). On histopathological examination, indeterminate leprosy (IL) (21 cases; 33.90%) was the most common followed by lepromatous leprosy (16 cases; 25.80%).  Overall clinico-histopathological correlation was seen in 36 cases (58. 06%) with maximum correlation seen in indeterminate leprosy (100%) and tuberculoid leprosy (TT) (100%). Conclusion: This study concludes that correlation of clinical and histopathological features along with bacterial index is more useful for accurate typing of leprosy than considering any of the single parameter alone so that early and appropriate treatment could be started.

scholarly journals Spectrum of Malignant Skin Lesion in Patients attending Nepalgunj Medical College and Teaching Hospital

2017 ◽  
Vol 2 (2) ◽  
pp. 156-161
Author(s):  
Reena Rana ◽  
G P Ghimire ◽  
S Gupta ◽  
M Singh ◽  
KK Jha ◽  
...  
Keyword(s):  
Skin Lesion ◽  
Clinical Diagnosis ◽  
Teaching Hospital ◽  
Malignant Tumor ◽  
Histopathological Examination ◽  
Cross Sectional Study ◽  
Histopathological Diagnosis ◽  
Cross Sectional ◽  
Medical College ◽  
Histopathological Correlation

IntroductionClinical diagnosis of dermatological manifestation of neoplastic skin lesion can pose a diagnostic difficulty at times. Histopathological diagnosis is mandatory for accurate characterization of disease entity for proper and timely management of cases.ObjectiveThe aim of this study was to analyze malignant tumor of skin with respect to age, sex, clinical features and histopathological features and to evaluate the accuracy of clinical diagnosis with histopathological correlation.MethodologyThis is hospital based cross-sectional study conducted at Nepalgunj Medical College and Teaching Hospital, Kohalpur from February 2010 to January 2011. A total of 70 histopathological specimens of skin biopsies were studied and correlated with the clinical diagnosis. The data was entered into Microsoft  office excel and analyzed using statistical package for social sciences (SPSS 17.0).ResultsMalignant tumor of skin constituted 21.4% of total cases. In malignant tumor, most common sites were head and neck regions followed by lower limb with keratinocytic tumors being in the majority. Most of the specimens (65.7%) were obtained as excisional biopsies.  Seven cases diagnosed as benign lesions clinically, turned out to be malignant on histopathological examination. Out of 13 cases in which clinical diagnosis was of malignancy, only 8 turned out to be malignant, thus for malignant lesions, the clinical diagnosis had a sensitivity of 53.3%, specificity of 90.9% and a positive predictive value of 61.5%.ConclusionsSquamous cell carcinoma was the most common malignant tumor in this study and histopathological correlation significantly modifies the overall management in dermatological disorders where clinical diagnoses are equivocal.Birat Journal of Health SciencesVol.2/No.1/Issue 2/ Jan - April 2017, Page: 156-161

scholarly journals A 29-Year-Old Male with Borderline Lepromatous Leprosy

2013 ◽  
Vol 3 (2) ◽  
pp. 109-112
Author(s):  
Lubna Khondker ◽  
Md. Shirajul Islam Khan ◽  
Md. Anwar Husain
Keyword(s):  
Peripheral Nerves ◽  
Histopathological Examination ◽  
Dorsal Surface ◽  
Lepromatous Leprosy ◽  
The Body ◽  
Lower Limbs ◽  
Upper Respiratory Tract ◽  
Medical College ◽  
Great Auricular Nerve ◽  
Ulcerative Lesions

Leprosy (Hansen’s disease) is a chronic granulomatous infectious disease that primarily affects the peripheral nerves, skin, upper respiratory tract mucosa, eyes and certain other tissues. It is diagnosable and curable if recognized early and treated adequately. A twenty nine-year-old male from Jessore, Bangladesh reported in Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh with the complaints of multiple erythematous, large, raised and circumscribed lesions with loss of sensations on different parts of the body, especially distal portions of all four limbs for last eight months. Subsequently he developed ulcers on the anesthetic fingers due to smoking and few ulcerative lesions on both feet. Skin examination revealed multiple erythematous, large nodular lesions on both sides of the cheek and forehead, multiple erythematous, indurated, large plaques with raised margin and central clearing on the trunk, waist and all four limbs, few satellite lesions around the large plaques on the trunk, few hypopigmented patches and plaques on buttock and lower limbs, multiple painless ulcers on dorsal surface of fingers of both hands, both lateral malleoluses and right sole. On examination of peripheral nerves, left great auricular nerve, both ulnar nerves and both common peroneal nerves were moderately enlarged and tender. Slit skin smear for AFB (modified Z-N stain) was done and revealed that there were large number of acid and alcohol-fast bacilli arranged in straight and curved parallel bundles with globular masses (cigar-bundle appearance), morphologically resembling Mycobacterium leprae. Skin biopsy for histopathological examination revealed extensive infiltration of macrophages in the dermis, separated from epidermis by narrow grenz zone, with destruction of skin adnexa. Few foci of poorly defined granuloma in dermis were also noted. The patient was managed with rifampicin, clofazimine, dapsone, prednisolone and omeprazole. Journal of Enam Medical College; Vol 3 No 2 July 2013; Page 109-112 DOI: http://dx.doi.org/10.3329/jemc.v3i2.16134

scholarly journals Patterns and determinants of treatment completion and default among newly diagnosed multibacillary leprosy patients: A retrospective cohort study

Heliyon ◽  
2021 ◽  
pp. e07279
Author(s):  
Veincent Christian F. Pepito ◽  
Arianna Maever L. Amit ◽  
Rae Erica D. Samontina ◽  
Sarah Jane A. Abdon ◽  
David Norman L. Fuentes ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Treatment Completion ◽  
Newly Diagnosed ◽  
Leprosy Patients ◽  
Multibacillary Leprosy
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