Clinical and histopathological study of lepra reactions from a tertiary care center in South India

Authors

  • Remya Prasannan Department of Dermatology, Government Medical College, Kozhikode, Kerala, India
  • Mamatha George Department of Dermatology, Government Medical College, Kozhikode, Kerala, India Calicut, India http://orcid.org/0000-0003-3061-4479
  • Binitha M. P. Department of Dermatology, Government Medical College, Kozhikode, Kerala, India
  • Lekha T. Department of Pathology, Government Medical College, Kozhikode, Kerala, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20175375

Keywords:

Type 1 lepra reaction, Type 2 lepra reaction

Abstract

Background: Clinical features and histopathology of leprosy and type 1 and type 2 reactions do not always match, though they are generally accepted as important for arriving at a diagnosis. We studied the varied clinical presentations and the correlation with histology in patients presenting with leprosy and type 1 and type 2 reactions.

Methods: All patients with clinical features of leprosy and those with features of type 1 and type 2 lepra reactions attending the department of Dermatology from August 2008 to August 2009 were included. Detailed history, clinical examination and skin biopsy findings were noted and correlated using descriptive statistics.

Results: Of the 138 patients included in the study, 24 cases of reactions were detected. Eighteen had type 1 (75%) and six had type 2 (25%) reaction. Correlation showed that dermal edema on histology was helpful in diagnosis of lepra reactions while neutrophilic infiltration favoured the diagnosis of type 2 reactions.

Conclusions: Histopathological features are helpful in the diagnosis of lepra reactions, however in cases of doubt, the diagnosis should be made on clinical grounds.

Author Biography

Mamatha George, Department of Dermatology, Government Medical College, Kozhikode, Kerala, India Calicut, India

Associate Professor of Dermatology

References

Singh K, Iyengar B, Singh R. Variation in clinical and histopathological classification in leprosy. Lepr India. 1983;55:472-7.

Sehgal VN, Rege VL, Rye M. Correlation between clinical and histopathological classification in leprosy. Int J Lepr. 1977;45;278-80.

Jerath VP, Desai SR. Diversities in clinical and histopathological classification in leprosy. Lepr India. 1982;54:130-3.

Moorthy N, Kumar P, Chatura KR, Chandrasekar HR, Basavaraja PK. Histopatholgical correlation of skin biopsies in leprosy. Indian J Dermatol Venerol Leprol. 2001;67:299-301.

Van Brakel WH, Khawas IB, Lucas SB. Reactions in leprosy: an epidemiological study of 386 patients in West Nepal. Lepr Rev. 1994;65:190-203.

Ramu G, Desikan KV. Reactions in borderline leprosy. Indian J Lepr. 2002;74:115-28.

Becx-Bleumink M. Relapses among leprosy patients treated with multidrug therapy. Experience in leprosy control program of the All Africa Leprosy and Rehabilitation and Training Center in Ethiopia. Practical difficulties with diagnosing relapse. Int J Lepr. 1992;60:421-35.

Scollard DM, Smith T, Bhoopat L, Theetranont C, Rangdaeng S, Morens DM. Epidemiologic characteristics of leprosy reactions. Int Lepr. 1994;62:550-67.

Schreuder AM. The occurrence of reactions and impairment in leprosy. Int J Lepr. 1998;60:159-69.

Sehgal VN, Sharma V. Reactions in leprosy--a prospective study of clinical, bacteriological, immunological and histopathological parameters in thirty-five Indians. Int J Dermat. 1988;15:412-9.

Sehgal VN, Rege VL, Mascarenhas MF. Pattern of reactions in leprosy: a clinical appraisal. Lepr India. 1977;49:221-8.

Rea TH, Levan NE. Erythema Nodosum Leprosum in a general hospital. Arch Dermatol. 1975;111:1575-80.

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Published

2017-11-23

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Original Research Articles