Farshchian Mahmood, Kheirandish Abulfazl
Department of Dermatology, Sina Hospital, Hamadan, Iran.
Int J Dermatol. 2004 Dec;43(12):906-10. doi: 10.1111/j.1365-4632.2004.02040.x.
Leprosy is considered a chronic disabling condition. Many clinical and immunological aspects of the disease remain ill defined.
The study of clinico-pathological and laboratory findings of patients with leprosy admitted to Sina Hospital, Hamadan, Iran, from 1991 to 2000.
This is a descriptive retrospective cross-sectional study. The statistical community comprised all patients diagnosed leprosy. This diagnosis was clinical and confirmed through pathology (skin-biopsy) and laboratory (peripheral smear) measures.
In this study, the disease was more common in males than females with a mean age of 48.5 +/- 16.2 years. Most of the patients were more than 40 years old. Among 12 patients in this study, six cases were urban and six cases were rural. Six cases were living in Hamadan province and two cases migrated to Hamadan province (one of them from Afghanistan and the other from Kurdestan). Clinical diagnosis was confirmed by pathology in 11 cases, but in one case the clinical diagnosis did not match the pathology. In four cases the clinical diagnosis did not match the peripheral smear. Eight cases were admitted just once. Four cases had a history of recurrence and readmission (two patients had one time recurrence and the other two patients had two recurrences). There was no difference in the clinical findings between first presentation and recurrence. From the point of complication and disability, extremity disability was more common than eye disability. Increased severity of complications was found in patients with a delayed diagnosis and incomplete treatment.
This study showed that a rapid and correct diagnosis and complete treatment was necessary for prevention of complication and disability in patients with leprosy. Also the accuracy of pathology (skin biopsy) in the diagnosis exceeded the peripheral smear. Skin biopsy is recommended to confirm the diagnosis in all cases of leprosy. In the absence of pathology, patients must be considered as multibacillary patients and treated as such.
麻风病被认为是一种慢性致残性疾病。该疾病的许多临床和免疫学方面仍不明确。
研究1991年至2000年期间入住伊朗哈马丹市西纳医院的麻风病患者的临床病理及实验室检查结果。
这是一项描述性回顾性横断面研究。统计群体包括所有被诊断为麻风病的患者。该诊断基于临床，并通过病理检查（皮肤活检）和实验室检查（外周涂片）得以确认。
在本研究中，该疾病在男性中比女性更为常见，平均年龄为48.5±16.2岁。大多数患者年龄超过40岁。在本研究的12名患者中，6例来自城市，6例来自农村。6例居住在哈马丹省，2例迁移至哈马丹省（其中1例来自阿富汗，另1例来自库尔德斯坦）。11例患者的临床诊断经病理检查得以确认，但有1例临床诊断与病理结果不符。4例患者的临床诊断与外周涂片结果不符。8例患者仅入院一次。4例患者有复发和再次入院史（2例患者复发一次，另外2例患者复发两次）。首次就诊和复发时的临床检查结果无差异。从并发症和残疾情况来看，肢体残疾比眼部残疾更为常见。诊断延迟和治疗不彻底的患者并发症严重程度增加。
本研究表明，对于预防麻风病患者的并发症和残疾，快速、正确的诊断及彻底的治疗是必要的。此外，病理检查（皮肤活检）在诊断中的准确性超过外周涂片。建议对所有麻风病病例进行皮肤活检以确诊。在没有病理检查结果的情况下，患者应被视为多菌型患者并进行相应治疗。
