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麻风病的临床组织学相关性:印度中部一家新成立的三级医疗中心的三年经验

Clinico-Histological Correlation in Hansen's Disease: Three-year Experience at a Newly Established Tertiary Care Center in Central India.

作者信息

Semwal Shruti, Joshi Deepti, Goel Garima, Asati Dinesh, Kapoor Neelkamal

机构信息

Department of Pathology, L N Medical College and J K Hospital, Bhopal, Madhya Pradesh, India.

Department of Pathology and Lab Medicine, AIIMS, Bhopal, Madhya Pradesh, India.

出版信息

Indian J Dermatol. 2018 Nov-Dec;63(6):465-468. doi: 10.4103/ijd.IJD_525_17.

Abstract

BACKGROUND

Hansen's disease is a chronic infectious disease caused by . It is characterized by a wide range of clinical and histological manifestations. Ridley-Jopling criteria are widely used for classifying leprosy. The demonstration of acid-fast bacilli on slit-skin smear examination and in skin biopsy aids in its diagnosis.

AIM

The aim of the present study was to perform clinico-histological correlation of skin lesions in all patients with a clinical suspicion of Hansen's disease.

MATERIALS AND METHODS

The study included skin biopsies of all suspected cases of Hansen's disease received over a period of 3 years. Hematoxylin and eosin and Fite-Faraco stained sections of all cases were examined. Corresponding slit-skin smears, if available, were also reviewed.

RESULTS

During the study, a total of 116 cases were clinically diagnosed as Hansen's disease. Clinico-histological correlation was obtained in 62.9% of the cases (73/116). The most common histological subtype of Hansen's disease was borderline tuberculoid (TT) (40/116). Seven cases were diagnosed as lepromatous leprosy, five as TT, four as histoid, one as indeterminate, and three cases diagnosed as erythema nodosum leprosum. Fite-Faraco stain was positive in 33/73 cases. Out of 116 cases, slit-skin smears were available for 43 cases and were positive in 23 cases.

CONCLUSION

Correlation between clinical, bacteriological, and morphological features is required for accurate classification of Hansen's disease. Clinical detection and morphological diagnosis of early lesions remain challenging, and the histological findings should always be interpreted in correlation with clinical findings.

摘要

背景

麻风病是一种由……引起的慢性传染病。其特点是具有广泛的临床和组织学表现。里德利 - 乔普林标准被广泛用于麻风病的分类。在皮肤涂片检查和皮肤活检中发现抗酸杆菌有助于其诊断。

目的

本研究的目的是对所有临床怀疑患有麻风病的患者的皮肤病变进行临床 - 组织学相关性分析。

材料与方法

该研究包括对3年内接收的所有疑似麻风病病例的皮肤活检。对所有病例的苏木精和伊红染色以及菲特 - 法拉科染色切片进行检查。如有相应的皮肤涂片,也进行复查。

结果

在研究期间,共有116例临床诊断为麻风病。62.9%的病例(73/116)获得了临床 - 组织学相关性。麻风病最常见的组织学亚型是界线类偏结核样型(TT)(40/116)。7例被诊断为瘤型麻风,5例为TT型,4例为组织样型,1例为未定类,3例被诊断为麻风结节性红斑。菲特 - 法拉科染色在33/73例中呈阳性。在116例中,43例有皮肤涂片,其中23例呈阳性。

结论

麻风病的准确分类需要临床、细菌学和形态学特征之间的相关性。早期病变的临床检测和形态学诊断仍然具有挑战性,组织学发现应始终结合临床发现进行解释。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1866/6233050/337e8c79d0e8/IJD-63-465-g002.jpg

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