麻风病黄斑病变的临床病理研究

A clinico-pathological study of macular lesions in leprosy.

作者信息

Kar P K, Arora P N, Ramasastry C V, Sayal S K, Dhaka R S

机构信息

Armed Forces Medical College and Command Hospital (SC), Pune.

出版信息

Indian J Lepr. 1994 Oct-Dec;66(4):435-42.

PMID:7714352

Abstract

One hundred twenty histologically confirmed cases of leprosy having macular lesions were evaluated clinically and histopathologically according to Ridley-Jopling classification. Of these 120 cases, the majority (91 or 75.8%) were young adults. The main clinical findings were: a single macule in 42 patients (35%), multiple macules 2-5 in numbers in 35 patients (29.1%), 6-10 macules in 17 patients (14.1%) and more than 10 macules in 26 patients (21.6%). Impairment of sensation over the macular lesions was present in 62 cases (51.6%), total loss of sensation was noticed in 31 patients (25.8%) and sensation was intact in 27 patients (22.5%). Acid-fast bacilli were detected in 11 cases (9.1%) by slit-skin smear examination. Clinical examination of the 120 cases revealed features of TT in 16 (13.3%), BT in 41 (34.1%), BB in 11 (9.1%), BL in 13 (10.8%), LL in 7 (5.8%) and indeterminate leprosy (IL) in 32 patients (26.6%). On the contrary, histologically there were 22 cases of TT (18.3%), 38 cases of BT (31.6%), 8 (6.5%) BB, 10 BL (8.3%), 7 LL (5.8%) and 35 cases of IL (29.1%). Histopathological features were consistent with the clinical picture in 84 patients (70%).

摘要

对120例经组织学确诊且有斑疹损害的麻风病例，根据里德利-乔普林分类法进行了临床和组织病理学评估。在这120例病例中，大多数（91例，占75.8%）为年轻人。主要临床发现为：42例患者（35%）有单个斑疹，35例患者（29.1%）有2 - 5个多个斑疹，17例患者（14.1%）有6 - 10个斑疹，26例患者（21.6%）有超过10个斑疹。62例（51.6%）斑疹损害处存在感觉障碍，31例患者（25.8%）感觉完全丧失，27例患者（22.5%）感觉正常。通过皮肤刮片检查在11例（9.1%）中检测到抗酸杆菌。对这120例病例的临床检查显示，16例（13.3%）为结核样型（TT），41例（34.1%）为界线偏结核样型（BT），11例（9.1%）为中间界线类（BB），13例（10.8%）为界线偏瘤型（BL），7例（5.8%）为瘤型（LL），32例患者（26.6%）为未定类麻风（IL）。相反，组织学上有22例TT（18.3%），38例BT（31.6%），8例BB（6.5%），10例BL（8.3%），7例LL（5.8%）和35例IL（29.1%）。84例患者（70%）的组织病理学特征与临床表现相符。