Thomas M
Indian J Lepr. 2013 Oct-Dec;85(4):159-62.
Histological changes suggestive of leprosy in clinically normal skin have been well documented in the lepromatous spectrum and rarely in the tuberculoid spectrum of the disease. This study attempts to evaluate the histology of clinically normal appearing skin in cases of borderline tuberculoid and tuberculoid leprosy. Biopsies from lesional and a clinically normal appearing skin from newly diagnosed patients with BT or TT leprosy seen in the outpatient department over a period of one year were evaluated by a blinded pathologist. Sixty five patients were included in the study. Six patients had granulomas in the normal skin, six others showed a histological pattern consistent with indeterminate leprosy in the biopsies taken from normal skin. The clinicians must be aware that a small percentage of cases in the TT spectrum also have involvement of normal appearing skin. These patients are at a high risk of under-treatment and may be a cause for paucibacillary relapse. This is a pilot study and a larger sample size is recommended to evaluate the real scenario.
在临床上看似正常的皮肤中出现提示麻风病的组织学变化，在瘤型麻风谱系中已有充分记录，而在结核样型麻风谱系中则很少见。本研究旨在评估界线类结核样型和结核样型麻风病例中临床上外观正常的皮肤的组织学情况。由一位不知情的病理学家对在一年时间里门诊新诊断的BT或TT麻风患者的皮损及临床上外观正常的皮肤活检样本进行评估。65名患者纳入本研究。6例患者正常皮肤中有肉芽肿，另外6例在取自正常皮肤的活检中显示出与未定类麻风一致的组织学模式。临床医生必须意识到，TT谱系中的一小部分病例也有外观正常的皮肤受累情况。这些患者存在治疗不足的高风险，可能是少菌型复发的一个原因。这是一项初步研究，建议采用更大样本量来评估实际情况。
