Leprosy Rev
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Comparative Study Clinical Trial
Presence of M. leprae in tissues in slit skin smear negative multibacillary (MB) patients after WHO-MBR.
This study looked for M. leprae in the lymph node, nerve and skin of multibacillary (MB) leprosy patients who become slit skin smear negative after the completion of WHO-MBR. Twenty-five WHO-MBR-treated multibacillary leprosy patients were studied; borderline lepromatous (BL) leprosy (n = 11) and lepromatous (LL) leprosy (n = 14)). Fifteen patients had reaction (erythema nodosum leprosum 11, upgrading reaction 4) either at presentation or during therapy. ⋯ Also, significantly more lymph node aspirates contained M. leprae in comparison with nerve or skin biopsies. All seven cases in whom treatment was extended beyond 24 months showed M. leprae in tissues even after attaining slit smear negativity. In conclusion, M. leprae persist in tissues after 2 years of WHO-MBR and patients with an initial BI of 4+ or more need to be closely followed up after stopping MDT.
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A case of borderline-lepromatous leprosy exhibiting alopecia of the scalp along with lepromatous lymphadenitis of suboccipital lymphnode is reported. To our knowledge generalized leprous alopecia of the scalp with lepromatous lymphadenitis of the suboccipital node is a rare occurrence in female Indian patients.
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Case Reports
Two unusual nerve abscesses--lepromatous leprosy and pure neural leprosy: case reports.
We report two cases of nerve abscesses, one suffering from lepromatous leprosy (LL) and the other from tuberculoid neural leprosy. Neither had any signs of reactions. ⋯ Surgical nerve decompression and systemic prednisolone had resolved the nerve abscess in the first case, whereas the second one responded only to surgical nerve decompression. The unusual nature of clinical presentation of nerve abscess has been outlined.
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A hundred and thirty-six apparently healthy volunteers between the ages of 16 and 67 were used to determine normative thresholds of tactile sensibility in the Nepali adult population. Tactile sensibility thresholds on standardized sites on hands and feet were assessed for two sensory tests: Semmes-Weinstein monofilaments (SWM) and moving-point discrimination (M2PD). Results are reported as the proportion of subjects able to feel a given threshold. ⋯ Normal thresholds for tactile sensibility were higher than those published for the North American population. Monofilament thresholds suitable for screening were 200 mg (log number 3 center dot 61) and 2 g (log number 4 center dot 31) for hand and foot, respectively. For moving 2-point discrimination on the hand this threshold was 4 mm.