Sehgal V N, Chaudhry A K
Department of Dermatology and Venereology, Lady Hardinge Medical College, New Delhi, India.
Int J Dermatol. 1993 Mar;32(3):194-7. doi: 10.1111/j.1365-4362.1993.tb02792.x.
Leprosy has been identified as an important health problem in the pediatric age group. The study of leprosy in children is imperative as it may unravel the missing links in the natural evolution of the disease and dispel the uncertainty of the precise incubation period.
The study was undertaken on patients attending the Urban Leprosy Centre. There were 161 children in the age group of 0 to 14 years, amongst 3184 cases of leprosy, detected between 1981 and 1991. The diagnosis in each was formed after meticulously recording the clinical features, slit-skin smear examination, and histopathologic characteristics. In addition, a detailed history of duration of the disease was elicited by complement recall method.
The study revealed an incidence of 5.06% amongst leprosy patients, in an urban setting. The boys:girls ratio was 2.6:1. The mean duration of the disease was 1.2 years in paucibacillary and 2.8 years in multibacillary. History of intra- or extrafamilial contact was elicited in 8.7%. The typical lesion was a "hypopigmented macule," either of indeterminate, tuberculoid, borderline tuberculoid, or borderline borderline leprosy. Borderline lepromatous, lepromatous, and polyneuritic leprosy were uncommon.
Leprosy in children is a well-established distinct entity. Any hypopigmented macule in pediatric age group should arouse suspicion of leprosy. The diagnosis is clinical. Other investigative parameters, namely slit-skin smear, and histopathology may supplement but not supplant the diagnosis.
麻风病已被确认为儿童年龄组中的一个重要健康问题。对儿童麻风病进行研究势在必行，因为这可能会揭示该疾病自然演变过程中缺失的环节，并消除对确切潜伏期的不确定性。
该研究针对前往城市麻风病中心就诊的患者开展。在1981年至1991年间检测出的3184例麻风病病例中，有161名年龄在0至14岁的儿童。通过仔细记录临床特征、皮肤涂片检查和组织病理学特征对每例进行诊断。此外，采用补充回忆法获取了疾病持续时间的详细病史。
该研究显示，在城市环境中，麻风病患者中的发病率为5.06%。男女比例为2.6:1。少菌型患者的疾病平均持续时间为1.2年，多菌型患者为2.8年。8.7%的患者有家庭内或家庭外接触史。典型病变为“色素减退斑”，见于未定类、结核样型、界线结核样型或界线类偏结核样型麻风。界线类偏瘤型、瘤型和神经炎型麻风并不常见。
儿童麻风病是一个已明确的独特实体。儿童年龄组中出现的任何色素减退斑都应引起对麻风病的怀疑。诊断依靠临床。其他检查参数，即皮肤涂片和组织病理学检查可作为补充，但不能取代诊断。
