Abstract
The diagnosis of single-lesion paucibacillary leprosy remains a challenge. Reviews by expert dermatopathologists and quantitative polymerase chain reaction (qPCR) results obtained from 66 single-plaque biopsy samples were compared. Histological findings were graded as high (HP), medium (MP) or low (LP) probability of leprosy or other dermatopathy (OD). Mycobacterium leprae-specific genes were detected using qPCR. The biopsies of 47 out of 57 clinically diagnosed patients who received multidrug therapy were classified as HP/MP, eight of which were qPCR negative. In the LP/OD (n = 19), two out of eight untreated patients showed positive qPCR results. In the absence of typical histopathological features, qPCR may be utilised to aid in final patient diagnosis, thus reducing overtreatment and delay in diagnosis.
Highlights
The diagnosis of leprosy is confirmed by evidence of acid-fast bacilli (AFB) in slit-skin smears or tissue samples or by the presence of characteristic histological alterations of the nerves or skin
Skin biopsy samples from 86 patients with a single plaque, but no previous history of leprosy, who attended the clinic for diagnostic purposes from January 2008-December 2011 were selected
The presence of Mycobacterium leprae-specific genes was detected using quantitative polymerase chain reaction (qPCR) and the results were compared to the histopathology grading and clinical data
Summary
The diagnosis of leprosy is confirmed by evidence of acid-fast bacilli (AFB) in slit-skin smears or tissue samples or by the presence of characteristic histological alterations of the nerves or skin. Because an accurate diagnosis in these cases is challenging, the results of reviews by expert dermatopathologists and quantitative polymerase chain reaction (qPCR) analyses of single-plaque biopsy samples were compared to evaluate previous therapeutic decisions. Skin biopsy samples from 86 patients with a single plaque, but no previous history of leprosy, who attended the clinic for diagnostic purposes from January 2008-December 2011 were selected.
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