Rashed Hassan A, Mearag Ibrahim, Saleh Naglaa Mostafa Kamel, Saied Ahmed
Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
J Egypt Soc Parasitol. 2009 Dec;39(3):933-42.
This study was carried out on 50 patients with different clinical types of leprosy 38 males (76 % and 12 females (24%), ages ranged from 14 -70 years with a mean age +/- SD 49.22 +/- 12.97 years. Mean disease duration was 5.65 years +/- SD = 9.27 selected to study a group of leprosy patients and compare the clinical parameters with histopathological findings and bacteriologic status of the skin to evaluate the relevance of their patients. Patients were subjected to full medical history taking including disease duration, type and duration of previous or current therapies. Complete clinical examination, for the determination of the clinical type of leprosy. Skin slit smear (SSS) and skin biopsies were taken and examined after staining for histopathological assessment and Acid fast bacilli (AFB). SPSS package version (statistical Package for Social Sciences) was used for data analysis. The biopsy of normally looking skin showed classic histopathological features of leprosy in more than half of the cases (26 cases, 52%). The histopathological types of leprosy diagnosed in such cases were as follows: indeterminate leprosy (IL) in 4 cases (15.38%), Tuberculoid leprosy (TL) in 2 cases (7.69%), Borderline tuberculoid (BT) in 4 cases (15.38), Borderline Borderline (BB) i.e Query in 8 cases (30.76%), Borderline Lepromatous (BL) in 7 cases (26.92%) and Lepromatous leprosy (LL) in a patient (3.84%). Other 24 cases showed either no evidence of leprosy in (9 cases, 37.5%), or query findings (in the form of sweat gland changes either alone or in combination with thickened nerves and superficial and deep perivascular lymphohistiocytic infiltrate) in 15 cases (62.5%). Histopathology of skin lesion biopsies showed TL in 3 cases (6%), BT in 8 cases (16%), BB in 8 cases (16%), BL in 14 cases (28%), LL in 12 cases (24%) and leprosy in reaction in 5 cases (10%). In 16 cases (32%), histopathological type of leprosy detected by microscopical examination of biopsies from skin lesions differed from that diagnosed by clinical examination.
本研究对50例不同临床类型的麻风病患者进行，其中男性38例（76%），女性12例（24%），年龄在14至70岁之间，平均年龄±标准差为49.22±12.97岁。平均病程为5.65年±标准差=9.27年，选取一组麻风病患者，比较其临床参数与组织病理学结果及皮肤细菌学状况，以评估它们之间的相关性。患者接受了全面的病史采集，包括病程、既往或当前治疗的类型和持续时间。进行了完整的临床检查，以确定麻风病的临床类型。采集皮肤刮片涂片（SSS）和皮肤活检样本，染色后进行组织病理学评估和抗酸杆菌（AFB）检查。使用社会科学统计软件包（SPSS）版本进行数据分析。正常外观皮肤的活检在半数以上病例（26例，52%）中显示出麻风病的典型组织病理学特征。此类病例中诊断出的麻风病组织病理学类型如下：未定类麻风（IL）4例（15.38%），结核样型麻风（TL）2例（7.69%），界线结核样型（BT）4例（15.38%），中间界线类（BB）即疑问型8例（30.76%），界线偏瘤型（BL）7例（26.92%），瘤型麻风（LL）1例（3.84%）。其他24例中，9例（37.5%）未显示麻风病证据，15例（62.5%）显示疑问性结果（表现为单独的汗腺改变或与神经增粗及浅、深血管周围淋巴细胞-组织细胞浸润合并出现）。皮肤病变活检的组织病理学显示，TL 3例（6%），BT 8例（16%），BB 8例（16%），BL 14例（28%），LL 12例（24%），麻风反应5例（10%）。在16例（32%）中，通过皮肤病变活检显微镜检查检测到的麻风病组织病理学类型与临床检查诊断的不同。
