Kumar S K, Reddy B S, Ratnakar C
Department of Dermatology & STD, JIPMER, Pondicherry, India.
Lepr Rev. 1996 Jun;67(2):119-25. doi: 10.5935/0305-7518.19960012.
Discrepancies have been noted in the histopathological findings between skin and nerve lesions of leprosy patients in some recent works. We studied concurrent skin and nerve biopsies in 27 randomly selected leprosy patients to correlate the histopathological features of skin and nerve lesions, and to assess the importance of neural histology in the classification of leprosy. Skin and nerve biopsies were diagnostic of leprosy in 23 and 26 patients, respectively. A discrepancy was found between the two in 15 cases. Neural histology was helpful in the classification of determinate forms in 24 cases while dermal histology was significant only in 16 patients. A multibacillary nerve and paucibacillary skin picture was observed in 3 patients. It was concluded that nerve biopsy is more informative and specific than skin biopsy in the diagnosis of leprosy and further helps to classify the patients when the skin histology is indeterminate or nonspecific.
近期一些研究发现,麻风病人皮肤和神经病变的组织病理学检查结果存在差异。我们对27例随机选取的麻风病人同时进行了皮肤和神经活检,以关联皮肤和神经病变的组织病理学特征,并评估神经组织学在麻风病分类中的重要性。皮肤活检和神经活检分别确诊了23例和26例麻风病人。两者结果存在差异的有15例。神经组织学对24例确诊型麻风病的分类有帮助,而皮肤组织学仅对16例病人有意义。3例病人呈现多菌型神经和少菌型皮肤表现。研究得出结论,在麻风病诊断中,神经活检比皮肤活检提供的信息更多且更具特异性,当皮肤组织学结果不确定或不具有特异性时,神经活检有助于对病人进行分类。