Skin Nerve Research Articles

Musculoskeletal manifestations in leprosy.

Leprosy, a chronic infectious disease caused by Mycobacterium leprae and Mycobacterium lepromatosis, primarily targets the skin and peripheral nerves, frequently leading to dermatological, neurological, and musculoskeletal complications. This review highlights the spectrum of musculoskeletal manifestations in leprosy, including acute arthritis during Type 2 reactions, chronic arthritis mimicking autoimmune diseases like rheumatoid arthritis, and neuropathic arthropathy. These manifestations underscore the complex interplay of inflammatory and immune mechanisms. Acute arthritis often involves both small and large joints, while chronic forms may present diagnostic challenges due to their resemblance to other inflammatory arthritides. Clinical management centers on multidrug therapy (MDT) for infection control, complemented by immunosuppressive or anti-inflammatory agents for reactional episodes. Recent advancements, such as biologics and synthetic immunosuppressants, have demonstrated efficacy in refractory cases, offering new therapeutic avenues. Heightened clinician awareness is essential for timely diagnosis and integrated management, particularly in endemic regions, to mitigate long-term disabilities and improve patient outcomes.

α-Synuclein distribution in olfactory mucosa and skin nerves in Parkinson disease associated with an EIF4G1 gene mutation.

The EIF4G1 gene has been considered an autosomal dominant cause of Parkinson disease (PD), even if its role is still debated. The objective of this study was to describe the phenotype and α-synuclein distribution in peripheral tissues in 2 related PD patients (mother and daughter), who are carriers of the same variant in exon 10 of EIF4G1 (c.1216G>A, p.Gly406Arg). We used the Burghart Sniffin Sticks test for olfactory function. α-Synuclein distribution in the olfactory mucosa and skin samples was analyzed using RT-QuIC, double immunofluorescence, and immunohistochemical staining. Both patients presented with a mild motor syndrome associated with hyposmia as prominent traits; pathological α-synuclein deposits were found in the olfactory mucosa but not in the skin. The phenotype and the findings in peripheral tissues suggest that PARK18 could manifest as a "benign" form of PD associated with hyposmia, with a slow progression and sparse α-synuclein accumulation in the peripheral nervous system.

Skin Eruption and Nerve Impairment: Eosinophil Activation Link.

Skin Eruption and Nerve Impairment: Eosinophil Activation Link.

A Rare Presentation of Type 2 Lepra Reaction: Necrotizing Erythema Nodosum Leprosum with Extensive Ulceration

Background: Leprosy, primarily caused by Mycobacterium leprae, is a chronic infectious disease that mainly affects the skin and peripheral nerves. Type 2 leprosy reaction (ENL) is an immune complex-mediated complication characterized by inflammation of the skin, nerves, and other organs. A less common manifestation of ENL is necrotizing ENL, which presents with extensive skin necrosis and ulceration. This case report describes a rare presentation of necrotizing ENL with extensive ulceration in a young woman with borderline lepromatous leprosy. Case presentation: A 20-year-old female presented with multiple, progressively enlarging, painless ulcers on her right leg and painful reddish nodules on her left arm and left leg. She had a history of borderline lepromatous leprosy. Dermatological examination revealed madarosis, infiltration, nodules, hyperpigmentation macules, ulcers, and blackish crusts. Sensory testing showed hypoesthesia in the abdomen and back, and anesthesia in both lower arms and legs. Histopathological examination confirmed the diagnosis of necrotizing ENL. Conclusion: Necrotizing ENL is a rare and severe complication of leprosy. This case highlights the importance of early diagnosis and appropriate management with multi-drug therapy and corticosteroids to prevent significant morbidity and disability.

Keratinocyte-derived extracellular vesicles in painful diabetic neuropathy.

Painful diabetic neuropathy (PDN) is a challenging complication of diabetes with patients experiencing a painful and burning sensation in their extremities. Existing treatments provide limited relief without addressing the underlying mechanisms of the disease. PDN involves the gradual degeneration of nerve fibers in the skin. Keratinocytes, the most abundant epidermal cell type, are closely positioned to cutaneous nerve terminals, suggesting the possibility of bi-directional communication. Extracellular vesicles are lipid-bilayer encapsulated nanovesicles released from many cell types that mediate cell to cell communication. The role of keratinocyte-derived extracellular vesicles (KDEVs) in influencing signaling between the skin and cutaneous nerve terminals and their contribution to the genesis of PDN has not been explored. In this study, we characterized KDEVs in a well-established high-fat diet mouse model of PDN using primary adult mouse keratinocyte cultures. We obtained highly enriched KDEVs through size-exclusion chromatography and then analyzed their molecular cargo using proteomic analysis and small RNA sequencing. We found significant differences in the protein and microRNA content of high-fat diet KDEVs compared to KDEVs obtained from control mice on a regular diet, including pathways involved in axon guidance and synaptic transmission. Additionally, using an in vivo conditional extracellular vesicle reporter mouse model, we demonstrated that epidermal-originating GFP-tagged KDEVs are retrogradely trafficked into the dorsal root ganglion (DRG) neuron cell bodies. This study presents the first comprehensive isolation and molecular characterization of the KDEV protein and microRNA cargo in RD and HFD mice. Our findings suggest a potential novel communication pathway between keratinocytes and DRG neurons in the skin, which could have implications for PDN.

Facial Thread Lifting Complications: Underlying Causes.

Thread lifting procedures are becoming increasingly popular for facial rejuvenation. However, various complications can arise during these procedures, many of which are influenced by anatomic factors. In this section, the authors explore the potential side effects associated with thread lifting and emphasize the anatomic structures that require careful attention. Techniques to mitigate these risks are also discussed, focusing on methods such as reticular cutis gathering and pinching techniques. Complications from thread lifting can include dimpling, protrusion, skin penetration due to skin tagging, parotitis, and nerve damage. These issues often stem from anatomic causes. In addition, granulomas, infections, and excessive fibrosis may occur, sometimes necessitating thread removal as the safest course of action. Proper techniques, such as reticular cutis gathering and pinching, can help minimize side effects and ensure the safe placement of threads within the intended layer. Aligning threads with tissue movement and the superficial musculoaponeurotic system (SMAS) layer is crucial to preventing complications or deep penetration. By focusing on anatomic structures and using careful techniques, the risks associated with thread lifting can be significantly reduced, leading to safer and more effective outcomes.

Slit skin smear versus anti-phenolic glycolipid-I serology in diagnosis of leprosy: a cross sectional study.

Leprosy is a chronic infectious disease which mainly affects the skin, nasal mucosa, and peripheral nerves. The aim of this study was to compare between the efficacies of serum anti-phenolic glycolipid 1 (APGL-I) level versus slit skin smear (SSS) in diagnosis of leprosy. This study involved 58 leprosy cases who were clinically examined, slit-skin smears were taken from all at diagnosis from four sites and APGL-I levels were seroassayed using ELISA. The mean age of studied group was 39.42 ± 15.2, 44.8% of patients were males and 55.2% were females. The majority of patients (72.4%) had multibacillary leprosy (MBL) followed by (27.6%) of patients had paucibacillary leprosy (PBL). SSS had sensitivity of 71.5% and specificity of 84% (area under curve; AUC = 0.763, 95% CI 0.427-0.823) while APGL-I had a sensitivity of 80% and specificity of 85% (area under curve; AUC = 0.830, 95% CI 0.424-0.852). Both serum Anti-PGL-1 levels and slit skin smear are useful in diagnosing leprosy, but their effectiveness depends on disease stage and patient's immune response. Being inexpensive, easy and noninvasive technique, APGL1 can be an adjunct method for the detection of leprosy in the population while slit skin smear having higher specificity. Combining both methods or using sequential diagnostic approaches could enhance accuracy and reduce missed diagnoses.

Transcriptome immune-regulatory differences between leprosy patients and type 1 reaction patients, before onset of symptoms.

Leprosy is a chronic disease of the skin and peripheral nerves caused by Mycobacterium leprae. A major public health and clinical problem are leprosy reactions, which are inflammatory episodes that often contribute to nerve damage and disability. Type I reversal reactions (T1R) can occur after microbiological cure of leprosy and affect up to 50% of leprosy patients. Early intervention to prevent T1R and, hence, nerve damage, is a major focus of current leprosy control efforts. In a prospective study, we enrolled and collected samples from 32 leprosy patients before the onset of T1R. Whole blood aliquots were challenged with M. leprae sonicate or media and total RNA was extracted. After a three-year follow-up, the transcriptomic response was compared between cells from 22 patients who remained T1R-free and 10 patients who developed T1R during that period. Our analysis focused on differential transcript (i.e. isoform) expression and usage. Results showed that, at baseline, cells from T1R-destined and T1R-free subjects had no main difference in their transcripts expression and usage. However, the cells of T1R patients displayed a transcriptomic immune response to M. leprae antigens that was significantly different from the one of cells from leprosy patients who remained T1R-free. Transcripts with significantly higher upregulation in the T1R-destined group, compared to the cells from T1R-free patients, were enriched for pathways and GO terms involved in response to intracellular pathogens, apoptosis regulation and inflammatory processes. Similarly, transcript usage analysis pinpointed different transcript proportions in response to the in-vitro challenge of cells from T1R-destined patients. Hence, transcript usage in concert with transcript expression suggested a dysregulated inflammatory response including increased apoptosis regulation in the peripheral blood cells of T1R-destined patients before the onset of T1R symptoms. Combined, these results provided detailed insight into the pathogenesis of T1R.

Histopathology of thermal effects in endoscopic ear surgery: An experimental animal study.

The potential risk of thermal damage in the transcanal endoscopic ear surgery has been a concerning issue. This study aimed to investigate the histopathological effects of heat exposure of different durations in external auditory canal (EAC) skin and facial nerve tissues. This study was conducted on 20 rabbits assigned equally to five groups according to the endoscope-transmitted heat exposure duration: Control group (no exposure), 2, 10, 15, and 30 min. At the end of the procedure, EAC skin and the tympanic segment of facial nerve tissue samples were taken surgically and histopathologically examined. Significant histopathological thermal damage findings in external auditory canal skin and facial nerve tissues were observed under endoscope-transmitted heat exposure longer than 15 and 10 min, respectively. This study demonstrated that prolonged exposure of the endoscope-transmitted heat can cause histopathological thermal damage in EAC skin and facial nerve on rabbit subjects.

Hyperpigmented macules surrounded by hypopigmented rim in a case of lepromatous leprosy

Introduction: leprosy is a chronic infectious mycobacterial disease caused by M. leprae. It primarily involves the skin and nerves, presenting with skin lesions and nerve enlargement. The skin lesions vary from hypopigmented, anesthetic macules/plaques to erythematous papules, plaques, and nodules, depending upon the type of leprosy.Hyperpigmented lesions in leprosy are rarely reported. Although hypopigmented lesions are commonly seen, perilesional hypopigmentation is a rare occurrence in leprosy. Perilesional hypopigmentation is seen as Woronoff’s ring around resolving lesions of psoriasis. A similar phenomenon called the halo phenomenon is associated with various skin tumors. Case Presentation: we describe a rare presentation of a leprosy case presenting with hyperpigmented lesions surrounded by a perilesional hypopigmented rim.

Antibody selection and automated quantification of TRPV1 immunofluorescence on human skin

Assessing localization of the transient receptor potential vanilloid-1 (TRPV1) in skin nerve fibers is crucial for understanding its role in peripheral neuropathy and pain. However, information on the specificity and sensitivity of TRPV1 antibodies used for immunofluorescence (IF) on human skin is currently lacking. To find a reliable TRPV1 antibody and IF protocol, we explored antibody candidates from different manufacturers, used rat DRG sections and human skin samples for screening and human TRPV1-expressing HEK293 cells for further validation. Final specificity assessment was done on human skin samples. Additionally, we developed two automated image analysis methods: a Python-based deep-learning approach and a Fiji-based machine-learning approach. These methods involve training a model or classifier for nerve fibers based on pre-annotations and utilize a nerve fiber mask to filter and count TRPV1 immunoreactive puncta and TRPV1 fluorescence intensity on nerve fibers. Both automated analysis methods effectively distinguished TRPV1 signals on nerve fibers from those in keratinocytes, demonstrating high reliability as evidenced by excellent intraclass correlation coefficient (ICC) values exceeding 0.75. This method holds the potential to uncover alterations in TRPV1 associated with neuropathic pain conditions, using a minimally invasive approach.

NURSING CARE FOR PATIENTS WITH LEPROSY TREATED BY PRIMARY CARE: INTEGRATIVE REVIEW

Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Its predilection for the skin and peripheral nerves gives this disease particular characteristics, making its diagnosis simple. Brazil continues to be the second country in the world in terms of the number of cases, after India. Approximately 94% of known cases in the Americas and 94% of newly diagnosed cases are reported in Brazil. The disease manifests itself in two stable and opposing poles (virchowian and tuberculoid) and two unstable groups (indeterminate and dimorphic). In another classification, the disease is divided into tuberculoid, borderline or dimorphic forms, which are divided into dimorphic-tuberculoid, dimorphic-dimorphic and dimorphic-lepromatous and lepromatous forms. Microscopic examination of smears is the most useful complementary test for diagnosis. Treatment of leprosy includes: specific chemotherapy, suppression of reactive eruptions, prevention of physical disability, physical and psychosocial rehabilitation. Polychemotherapy based on rifampicin, dapsone and clofazimine has proven to be very effective and the prospects for controlling the disease in Brazil are real in the short term.

Diagnostic And Post-Therapeutic Histopathology Of Hansen’s Disease in a Man With Rheumatoid Arthritis

Abstract Introduction/Objective Hansen’s Disease (leprosy), caused by Mycobacterium leprae, is a chronic infectious disease primarily affecting the skin and peripheral nerves. In the United States, leprosy remains rare, with less than 200 cases per year reported to the CDC. Diagnosis is often delayed, due to low clinical suspicion and lack of experience among healthcare providers, leading to potentially severe complications and increased transmission risk. Methods/Case Report A 71-year-old man presented to dermatology with a progressive, non-tender erythematous rash involving the arms and chest. He denied any travel history, or exposure to armadillos, and had no family history of a similar rash. His medical history was significant for rheumatoid arthritis, for which he was receiving methotrexate. The clinical differential included drug eruption, tinea infection, or sarcoidosis. Skin biopsy revealed extensive infiltration of the dermis by noncaseating granulomas surrounding cutaneous nerves, and AFB stain highlighted numerous bacilli consistent with Mycobacterium leprae, leading to the diagnosis of Hansen’s disease. The WHO classification was multibacillary leprosy, and the Ridley-Jopling classification was borderline tuberculoid (BT) to perhaps mid borderline (BB), based on clinical and histologic features. He was started on triple therapy, and biopsies performed during treatment, as well as at three years follow up showed marked improvement, with some remaining disease detected in unresolved rash. Results (if a Case Study enter NA) NA Conclusion This case presents a diagnostic challenge given the absence of typical risk factors for Mycobacterium leprae transmission. The patient’s immunocompromised status due to methotrexate therapy may have predisposed him to the disease. Documented cases of Hansen’s disease have more than doubled in the southeastern states since 2013, with concern for endemic regions emerging in Florida. Early recognition, classification, and prompt treatment are essential to prevent disease progression and reduce transmission. Increased education and awareness among healthcare providers are crucial to improving diagnostic accuracy and patient outcomes in cases of leprosy.

Acid-Sensing Ion Channels Drive the Generation of Tactile Impulses in Merkel Cell-Neurite Complexes of the Glabrous Skin of Rodent Hindpaws.

Merkel cell-neurite complexes (MNCs) are enriched in touch-sensitive areas, including whisker hair follicles and the glabrous skin of the rodent's paws, where tactile stimulation elicits slowly adapting type 1 (SA1) tactile impulses to encode for the sense of touch. Recently, we have shown with rodent whisker hair follicles that SA1 impulses are generated through fast excitatory synaptic transmission at MNCs and driven by acid-sensing ion channels (ASICs). However, it is currently unknown whether, besides whisker hair follicles, ASICs also play an essential role in generating SA1 impulses from MNCs of other body parts in mammals. In the present study, we attempted to address this question by using the skin-nerve preparations made from the hindpaw glabrous skin and tibial nerves of both male and female rodents and applying the pressure-clamped single-fiber recordings. We showed that SA1 impulses elicited by tactile stimulation to the rat hindpaw glabrous skin were largely diminished in the presence of amiloride and diminazene, two ASIC channel blockers. Furthermore, using the hindpaw glabrous skin and tibial nerve preparations made from the mice genetically deleted of ASIC3 channels (ASIC3-/-), we showed that the frequency of SA1 impulses was significantly lower in ASIC3-/- mice than in littermate wild-type ASIC3+/+ mice, a result consistent with the pharmacological experiments with ASIC channel blockers. Our findings suggest that ASIC channels are essential for generating SA1 impulses to underlie the sense of touch in the glabrous skin of rodent hindpaws.

Profile of Leprosy Patients at the Dermatology and Venereology Polyclinic of Dr. M. Djamil Padang Hospital in 2018-2021

Leprosy is a chronic infectious disease caused by Mycobacterium leprae that attacks several parts of the body, especially the upper respiratory tract, skin, and peripheral nerves. Indonesia is the third country with the most leprosy in the world. This study aims to determine the profile of leprosy patients at the Dermatology and Venereology Polyclinic Dr. M. Djamil Padang Hospital in 2018-2021. This research is descriptive retrospective with total sampling technique using secondary data in the form of medical records. The sample of this study were all leprosy patients in 2018-2021 who were fulfilled inclusion criteria, with a total of 39 patients. The results showed that the most age group was >14 years (100%), the most gender was male (74.36%), the most residence was Padang (33.33%), and almost all leprosy patients (92.31%) had no history of household contact with leprosy patients. Most of the leprosy patients were of the multibacillary type (74.36%) with positive smear results (46.15%), without leprosy reaction (61.54%), and the most disability level that occurred was grade 0 disability (48.72%). The conclusion of this study is that most cases of leprosy at the Dermatology and Venereology Polyclinic RSUP Dr. M. Djamil Padang in 2018-2021 aged >14 years, male, having address in Padang City, had no history household contact, multibacillary type, positive smear result, without reaction, and level 0 disability.

Clinically Suspicious Cases of Hansen's Disease at a Tertiary Care Hospital in South India: A Clinicopathological Study.

Background and objective Hansen's disease, also known as leprosy, is a chronic granulomatous condition caused by Mycobacterium leprae, primarily affecting the skin and peripheral nerves. The disease has a wide spectrum of clinical and histopathological manifestations, often mimicking other inflammatory and infectious conditions. This variability poses significant challenges in its early diagnosis and management. Aligning clinical suspicion with histopathological evidence is critical for effective treatment and control of transmission. This study was designed to explore the concordance between clinical impressions and histopathological diagnoses and to understand the diagnostic utility of various histopathological techniques. We aimed to establish and correlate the histopathological types of leprosy with clinical presentations. We also sought to determine the extent to which different histopathological techniques, including special stains, can corroborate with clinical types, thereby enhancing diagnostic precision. Materials and methods This was a hospital-based, retrospective study of clinically suspicious cases of leprosy at a tertiary care hospital in South India. A total of 100 cases of various age groups were identified and included in the study. All cases underwent skin biopsy with samples subjected to routine hematoxylin and eosin (H&E) staining and acid-fast bacilli (AFB) staining for the detection oflepra bacilli. Results Among the 100 clinically suspicious cases of leprosy, 50were histopathologically confirmed as leprosy and 50were categorized as non-specific dermatitis. Among the 50 histologically confirmed cases of leprosy, the most common type was lepromatous leprosy (LL) (38%) followed by borderline tuberculoid (BT) (30%) leprosy.Modified AFBstain was positive in 21 cases and was instrumental in confirming the suspected cases of leprosy. The overall correlation between the clinical and histopathological diagnosis was significant, with the highest correlation noted in LL cases. Conclusions Our findings underscorethe complexity of diagnosing leprosy due to its varied clinical and pathological presentations. Despite a high overall concordance rate, the discrepancies between clinical impressions and histopathological findings observed highlight the need for a multidimensional diagnostic approach. Incorporating a combination of clinical assessment, routine histology, and special staining can enhance diagnostic accuracy, leading to better patient management and outcomes.

A - 115 Cognitive Predictors of Phosphorylated Skin Nerve α-Synuclein Deposition in Patients with Suspected Synucleinopathy

Abstract Objective Synucleinopathies are a group of neurodegenerative diseases caused by abnormal α-Synuclein aggregates and characterized by motor, autonomic, and cognitive changes, including Parkinson’s disease, Lewy Body disease, and Multiple System Atrophy. Due to variability in presentation, clinical phenotyping is challenging for diagnosis and treatment planning. Phosphorylated α-Synuclein (P-syn) detected in nerve fibers using skin biopsy shows promise in clinical phenotyping of synucleinopathies. However, cognitive predictors of P-syn deposition in synucleinopathies have not been fully explored. This study aimed to examine the utility of cognitive testing in predicting P-syn deposition in a clinical sample. Method A chart review of 52 older adults (Mean age = 72.8 years) referred to an outpatient neurology clinic for a diagnostic dementia workup was conducted. Clinical variables were collected, including skin biopsy (Syn-One) and cognitive test scores (Short Test of Mental Status [STMS]). P-syn was detected in 22 patients (42%) and at 68%, 41%, and 55% of central (neck) and distal (thigh and calf) biopsy sites, respectively. Results Overall cognition (STMS Total) did not significantly differ between patients with (Mean = 30.5) and without (Mean = 29.6) P-syn (p = 0.51). Within the P-syn positive group, STMS Registration-Trials and Calculation scores significantly predicted distally deposited P-syn (F(1,18) = 7.54, p = 0.01). This relationship was more pronounced in the thigh compared to the calf biopsy sites. Conclusion STMS Registration-Trials (immediate recall) and Calculation scores were significantly related to distally deposited P-syn. These findings highlight the importance of how cognitive test performance can potentially impact clinical phenotyping in synucleinopathies. Future research will examine the relationship between cognition, clinical features, and other neurodegenerative disease biomarkers.

Analysis of artificial intelligence medical treatment for closed muscle skin nerve injury caused by aerobics training

In aerobics training, closed myocutaneous nerve damage needs to be paid attention to, especially high-intensity training may cause minor damage to muscles and nerves. With the help of AI medical technology and the understanding of molecular and cellular biomechanics, we can more accurately explore the mechanism of injury, such as the effects of nerve tensile stress and microenvironment changes on nerve regeneration. This helps to develop scientific rehabilitation methods, such as AI-assisted personalized training, neural regeneration technology, and real-time monitoring of training intensity to speed up athletes’ rehabilitation and reduce the risk of future injuries. Purpose: Aerobics training is very strict and requires high physical fitness of dancers. During long-term training, dancers can easily cause closed musculocutaneous nerve injury. Traditional medicine is difficult to guarantee the treatment effect of patients with musculocutaneous nerve injury. The use of artificial intelligence medicine for closed musculocutaneous nerve injury treatment can improve the treatment effect of aerobics training induced closed musculocutaneous nerve injury. Method: This article utilized artificial intelligence medicine for the treatment of musculocutaneous nerve injury, and used artificial intelligence technology to analyze patient imaging and other data to assist doctors in accurate diagnosis. Utilize intelligent algorithms to predict medication plans, reduce medication errors, and intelligently adjust the course of treatment based on the patient’s condition. In artificial intelligence healthcare, high-quality online medical services can be created through intelligent technology, providing convenient medical consultation for patients. Result: This article selected 200 patients with musculocutaneous nerve injury caused by aerobics training for grouping experiments. The average diagnostic accuracy of traditional medicine and artificial intelligence medicine were 84.2% and 95.6%, respectively. Conclusion: Artificial intelligence medicine can achieve medical informatization and intelligently analyze patients’ medical information, which helps to improve the accuracy of medical diagnosis for aerobics training injuries.

Keratinocyte-Derived Exosomes in Painful Diabetic Neuropathy.

Painful diabetic neuropathy (PDN) is a challenging complication of diabetes with patients experiencing a painful and burning sensation in their extremities. Existing treatments provide limited relief without addressing the underlying mechanisms of the disease. PDN involves the gradual degeneration of nerve fibers in the skin. Keratinocytes, the most abundant epidermal cell type, are closely positioned to cutaneous nerve terminals, suggesting the possibility of bi-directional communication. Exosomes are small extracellular vesicles released from many cell types that mediate cell to cell communication. The role of keratinocyte-derived exosomes (KDEs) in influencing signaling between the skin and cutaneous nerve terminals and their contribution to the genesis of PDN has not been explored. In this study, we characterized KDEs in a well-established high-fat diet (HFD) mouse model of PDN using primary adult mouse keratinocyte cultures. We obtained highly enriched KDEs through size exclusion chromatography and then analyzed their molecular cargo using proteomic analysis and small RNA sequencing. We found significant differences in the protein and microRNA content of HFD KDEs compared to KDEs obtained from control mice on a regular diet (RD), including pathways involved in axon guidance and synaptic transmission. Additionally, using an in vivo conditional extracellular vesicle (EV) reporter mouse model, we demonstrated that epidermal-originating GFP-tagged KDEs are retrogradely trafficked into the DRG neuron cell body. Overall, our study presents a potential novel mode of communication between keratinocytes and DRG neurons in the skin, revealing a possible role for KDEs in contributing to the axonal degeneration that underlies neuropathic pain in PDN. Moreover, this study presents potential therapeutic targets in the skin for developing more effective, disease-modifying, and better-tolerated topical interventions for patients suffering from PDN, one of the most common and untreatable peripheral neuropathies.

“Histopthological Spectrum Of Leprosy In A Tertiary Care Centre”

Background: Leprosy affects skin and peripheral nerves, muscles, eyes, bones, testis and internal organs. Histopathology and demonstration of lepra bacilli is a vital role to supplement clinical examination and diagnosis for correct classification and therefore for patients treatment. Aim- To study the Histopathology spectrum of Leprosy in a tertiary care centre. Materials &Methods: All the skin biopsy with clinically suscipious of leprosy and sent for histopathological examination during the year Jan 2020 to Dec 2024 were included in the study. Results: A total of 60 cases were studied out of them 61% are male and 39% are female. With M:F ratio1.56: 1, majority of them belongs to 41-50 age group. The commonest histological type was borderline TB leprosy followed by Borderline lepromatous leprosy, least common cases were of lepromatous leprosy and histoid leprosy. Conclusion: Histopathological examination is the important investigation for accurate diagnosing and typing of leprosy