Evaluation of Clinical Spectrum with Comparison of Bacteriological Index in Slit Skin Smear and Histopathology among Newly Detected Hansen’s Disease Patients

Arunkumar, B (2020) Evaluation of Clinical Spectrum with Comparison of Bacteriological Index in Slit Skin Smear and Histopathology among Newly Detected Hansen’s Disease Patients. Masters thesis, Tirunelveli Medical College, Tirunelveli.

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Abstract

INTRODUCTION: Leprosy is a chronic, infectious disease caused by Mycobacterium leprae. It is classified into five groups based on clinical, histological, microbiological and immunological criteria (Ridley & Jopling Classification). However, a great variation has been observed in the interpretation of histopathological examination of skin biopsies and clinical presentation of the disease. Slit skin smear is the simplest and valuable test which is used in 1. confirm the diagnosis of leprosy. 2. To classify the disease.3)To follow- up patients on treatment. This study is intended to demonstrate the correlation between clinical with bacteriological index in slit skin smear and histopathology among newly diagnosed Hansen’s disease patient. AIMS AND OBJECTIVES: This is a prospective observational study done on newly detected leprosy patients at Tirunelveli Medical College Hospital from January 2018 to December 2018 with the following objectives. 1. To study the clinical profile of newly registered leprosy patients attending Dermatology Department in Government Medical College, Tirunelveli. 2. To observe the correlation between the clinical profile with slit skin smear and histopathological features in different types of leprosy. METHOD: All cases attending the Hansen OPD/IPD were examined clinically and Slit Skin Smear was taken and stained with Ziehl-Neelsen stain for Acid Fast Bacilli. Skin Biopsy specimen was obtained from clinically diagnosed cases of Leprosy and stained with Hematoxylin & Eosin and modified Fite Ferraco. The clinical diagnosis correlated with Slit skin smear and histopathological features in different types of leprosy. RESULTS: Total number of newly diagnosed leprosy cases 26. BTHD (15 patients) was the most common presentation TTHD & BTHD(3 patients), LLHD and Histoid hansen (2 patients each) and one patient was diagnosed to have BBHD. Highest concordance was observed in TTHD, LLHD, Histoid (100%) followed by BLHD (66.6%), BTHD (60%) and BBHD (0%). Clincohistopathological concordance was seen in 69.2% cases, and 30.8% cases shows discordance. Eight patients (30.8%) were smear positive for Acid Fast Bacilli(AFB). Of the 15 cases of BTHD, only 1 patient was smear positive (BI 1 +). All BLHD patients had BI 3+ to 4+. All LLHD and histoid patients had BI 5+ to 6+. All TTHD & BBHD smear negative. CONCLUSION: The clinical and histopathological features along with bacteriological index in slit skin smear are useful than any single parameter in arriving definitive diagnosis and classification of the leprosy.

Item Type: Thesis (Masters)
Additional Information: 201730252
Uncontrolled Keywords: Leprosy, Hansen’s disease, Slit skin smear, Histopathology, Bacteriological index.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Subramani R
Date Deposited: 05 Feb 2021 03:13
Last Modified: 05 Feb 2021 14:43
URI: http://repository-tnmgrmu.ac.in/id/eprint/13883

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