A Study of Clinical Presentation and Histopathology of Childhood Leprosy.

Murugan, S (2007) A Study of Clinical Presentation and Histopathology of Childhood Leprosy. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION : Leprosy is one of the oldest disease of mankind. Eventhough tremendous progress has been made in the field of leprosy elimination, it still continues to be an endemic problem in certain parts of India. India represents close to 76% of the global burden. Leprosy is a well documented entity in children. The overall prevalence of leprosy in India has declined from 5.27 / 10000 in the year 2000 to 1.34 / 10000 in the year 2005, still it constitutes a sizable health problem in the pediatric age group with an incidence of 13.3 % in children between the age group 0 -14years. Children between 0 - 14 years age group constitute approximately 30 % of the population. The worldwide prevalence of leprosy has decreased dramatically, since the inception of elimination plan, but the disease deduction rate has remained almost constant over the past ten years, with a high rate (17 %) of infection in children. Leprosy in children has epidemiological significance and can be considered as an index of the prevalence of the disease in the population. A high child rate may indicate continuing spread of the disease in the community. A case detected among children also provides an opportunity to detect the index case usually with in the family. Leprosy in children forms an important link in the study of the natural evolution of the disease. The spectrum of the disease is usually incomplete in children. It could be said that leprosy in children reflects to some extent practically all aspects of the disease in adults, with additional features of its own. Leprosy in children is common, but rare under 2 years of age. It is often unrecognized and 75% of cases regress spontaneously without treatment. Prevalence rate increases regularly in the age group 0-4, 5-9 and 10-14 years. The youngest age reported for occurrence of leprosy is 3 weeks in Martinique. The youngest case of tuberculoid leprosy confirmed by histopathology was in an infant of 2.5months old. Leprosy in children is equally prevalent in both sexes. Children are susceptible to leprosy, as the immune system is not fully developed. In children it presents predominantly as paucibacillary indeterminate, tuberculoid, borderline tuberculoid and occasionally borderline borderline, borderline tuberculoid being the most commonest. Borderline lepromatous and lepromatous leprosy are rare. This appears to be a paradoxical situation in children and runs counter to the concept that immune responses are either negligible or poorly developed in children. Childhood leprosy usually responds rapidly to treatment. Reactions and relapses are not uncommon in children. Ocular leprosy, deformities, infectivity, poor tolerance to antileprosy drugs, and special variants like histoid leprosy are rare in children. 38 AIM OF THE STUDY : This study was done to find out the following in childhood leprosy 0 to 14 years age group. 1. Common age group of leprosy in children. 2. Sex incidence. 3. Duration of the disease. 4. History of household contact. 5. Clinical presentation – morphology, color, number size and common site of skin lesion, common peripheral truncal nerve and cutaneous nerve involvement. 6. Common spectrum of the disease. 7. Reactions. 8. Deformity. 9. Slit skin smear. 10. Histopathological examination of skin and nerve biopsy. CONCLUSION : Leprosy in children - The commonest age group of occurrence is 10 to 14 years. Incidence is more among male children than female children, because of increased exposure of boys, due to cultural and socio-economic factors. Duration of disease is usually < 1 year. Father is the most common index case among household contacts. Single skin lesion, which occurs predominantly over the exposed parts, is the most common presenting feature. Ulnar nerve is the most commonly involved truncal nerve and radial cutaneous nerve is the most commonly involved cutaneous nerve. Borderline tuberculoid is the commonest spectrum. Leprosy towards lepromatous pole is rare among children, indicating clearly the spectrum is incomplete. Pure neuritic leprosy occurs in children in a sizable proportion. Reactions, predominantly Type I reactions, relapse and deformities do occur in children, even though rare.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Histopathology ; Childhood Leprosy ; Clinical Presentation Study.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Subramani R
Date Deposited: 05 Jul 2017 01:33
Last Modified: 05 Jul 2017 08:23
URI: http://repository-tnmgrmu.ac.in/id/eprint/940

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