Department of Dermatology, Era's Lucknow Medical College and Hospital, Lucknow Era University, Lucknow, Uttar Pradesh, India.
Int J Mycobacteriol. 2020 Apr-Jun;9(2):209-211. doi: 10.4103/ijmy.ijmy_7_20.
Mycobacterium leprae is a noncultivable mycobacteria, and diagnosis of the disease is based on its clinical and histopathological characteristics and finding the bacteria in skin scrapings and in biopsies taken from the patients. The aim of this study was to shed light on the clinical classification (based on the number of skin lesions) used extensively in the field where patients classified as paucibacillary (PB) were positive on skin smears and histopathology leading to treatment failure and drug resistance.
In this study, we enrolled untreated 62 leprosy patients with 1-5 skin lesions and did a detailed bacterio-histopathological analysis by slit-skin smears (SSSs) and histopathology.
Of 62 patients analyzed, 15 patients came out to be multibacillary (MB) and 47 were PB by SSS and histopathology.
The findings of the present study showed that the WHO classification of leprosy based on the number of lesions seems to be inappropriate as it considers a number of MB lesions as PB only, thus misleading the treatment strategies. Hence, it is essential that a comprehensive clinicobacteriological assessment of leprosy cases should be done to ensure the appropriate bacillary status and guiding the appropriate treatment strategy.
麻风分枝杆菌是一种不可培养的分枝杆菌,其疾病的诊断基于其临床和组织病理学特征,以及在皮肤刮屑和患者活检中发现细菌。本研究旨在阐明在临床上广泛应用的分类(基于皮肤损伤数量),在该分类中,被分类为少菌型(PB)的患者在皮肤涂片和组织病理学上呈阳性,导致治疗失败和耐药性。
在这项研究中,我们招募了未经治疗的 62 例有 1-5 处皮肤损伤的麻风病患者,并通过皮肤切片(SSSs)和组织病理学进行详细的细菌组织病理学分析。
在分析的 62 例患者中,有 15 例为多菌型(MB),47 例为 SSS 和组织病理学上的 PB。
本研究的结果表明,世界卫生组织基于病变数量的麻风病分类似乎不合适,因为它仅将一些 MB 病变归类为 PB,从而误导了治疗策略。因此,必须对麻风病病例进行全面的临床细菌学评估,以确保适当的细菌状态,并指导适当的治疗策略。