The development of cutaneous lesions during follow-up of patients with primary neuritic leprosy
| Autor: | Chinoy J. G. Chacko, Arunthathi Sigamoni, Sujai Suneetha, Nisha Kurian |
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| Rok vydání: | 2005 |
| Předmět: |
Borderline tuberculoid leprosy
Adult Male Pathology medicine.medical_specialty Adolescent Neuritis Dermatology Skin Diseases Lesion Biopsy Medicine Humans Aged Retrospective Studies Nerve biopsy medicine.diagnostic_test business.industry Histology Middle Aged medicine.disease Leprosy Tuberculoid Skin biopsy Female Leprosy medicine.symptom business Follow-Up Studies |
| Zdroj: | International journal of dermatology. 44(3) |
| ISSN: | 0011-9059 |
| Popis: | Background Primary neuritic leprosy (PNL) is a rare form of leprosy where the characteristic skin lesions are absent. Investigations of apparently normal skin from the areas of sensory change have revealed microscopic evidence of nerve involvement. Clinical studies have found that a proportion of patients develop visible skin lesions during follow-up. The aim of the study was to perform a clinical and histological analysis of PNL patients who developed visible skin lesions during treatment and follow-up, to gain insight into the pathogenesis of the disease. Methods Twenty-nine individuals in a series of 182 PNL patients developed visible skin lesions during follow-up. Analysis of the number, location, histology and time of onset of the new skin lesions in relation to the type and regularity of the treatment regimen were noted. A biopsy from the new skin lesion when available was compared with the nerve biopsy findings at the time of initial diagnosis. Results Thirty-eight per cent of patients developed a single patch and 28% developed two patches. Over three-quarters of these were on the lower limb (47%) or the upper limb (29%). Sixty-two per cent of patients developed the lesions within 2 years of the onset of symptoms. Patients on regular treatment developed patches earlier than those on irregular treatment or no treatment. A skin biopsy from the new patch revealed borderline tuberculoid leprosy histology in 47% of the patients. Conclusions The findings suggest that leprosy primarily affects the nerve and that a neuritic phase precedes the development of visible cutaneous lesions. |
| Databáze: | OpenAIRE |
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