National Reference Center in Sanitary Dermatology and Leprosy, Hospital das Clinicas, Av. Aspirante Mega, 77, Bairro Jaraguá, 38413-018 Uberlândia/MG, Brazil.
Acta Derm Venereol. 2011 Oct;91(6):704-7. doi: 10.2340/00015555-1175.
Oral lesions are rarely reported in paucibacillary forms of leprosy. We report here a case with an erythematous hyposensitive lesion in the palate and no skin lesions. In addition to routine tests, biopsies of the lesion in the palate and of clinically normal surrounding areas were performed and subjected to real-time PCR for detection of Mycobacterium leprae DNA. The biopsy of the oral lesion was positive for bacilli DNA, followed by positive serum anti-PGL-1 and Mitsuda test, but with negative histopathology. The patient was diagnosed with a borderline tuberculoid form. After multidrug therapy the lesion had significantly regressed and the bacilli DNA detection in the former lesion was negative. The bacilli DNA detection in an oral lesion by real-time PCR not only improved leprosy diagnosis, but also helped in the classification of clinical form, and in the establishment of the appropriate therapeutic regime.
口腔病变在少菌型麻风中很少报道。我们在此报告一例 palate 出现红斑性感觉迟钝病变且无皮肤病变的病例。除了常规检查外，还对 palate 病变和临床正常周围区域进行了活检，并进行实时 PCR 检测麻风分枝杆菌 DNA。口腔病变的活检呈杆菌 DNA 阳性，随后血清抗 PGL-1 和 Mitsuda 试验阳性，但组织病理学阴性。该患者被诊断为边界结核样型。多药治疗后，病变明显消退，原病变中杆菌 DNA 检测阴性。实时 PCR 检测口腔病变中的杆菌 DNA 不仅改善了麻风病的诊断，还有助于临床分型，并确定适当的治疗方案。
