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Narang T, Almeida JG, Kumar B, Rao PN, Suneetha S, Andrey Cipriani Frade M, Salgado CG, Dogra S. Fixed duration multidrug therapy (12 months) in leprosy patients with high bacillary load - Need to look beyond. Indian J Dermatol Venereol Leprol 2024; 90:64-67. [PMID: 37609736 DOI: 10.25259/ijdvl_278_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/08/2023] [Indexed: 08/24/2023]
Affiliation(s)
- Tarun Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Joel G Almeida
- Public Health and Epidemiology, Public Health Consultancy, Mumbai, India
| | - Bhushan Kumar
- Department of Dermatology, Silver Oaks Hospital, SAS Nagar, Punjab, India
| | - P Narasimha Rao
- Department of Dermatology, Bhaskar Medical College, Telangana, Hyderabad, India
| | - Sujai Suneetha
- Institute for Specialized Services in Leprosy (INSSIL), Nireekshana, Hyderabad, India
| | - Marco Andrey Cipriani Frade
- Department of Medical Clinics, Dermatology Division, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Sunil Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Mahendradas P, Rajendran J, Sriram R. Moth-Eaten Appearance of the Iris in Hansen Disease. JAMA Ophthalmol 2023; 141:e232470. [PMID: 37971507 DOI: 10.1001/jamaophthalmol.2023.2470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
This case report discusses the bilateral moth-eaten appearance of the irides of a woman in her 60s who presented with gradually decreasing vision and a history of Hansen disease.
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Affiliation(s)
| | - Jananee Rajendran
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Radhika Sriram
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
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Li J, Wang CH, Yu DH, He Q, He W. One Case of Tuberculosis-Like Leprosy with a Type I Leprosy Reaction. Clin Cosmet Investig Dermatol 2023; 16:2517-2523. [PMID: 37745274 PMCID: PMC10516185 DOI: 10.2147/ccid.s421159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/20/2023] [Indexed: 09/26/2023]
Abstract
Leprosy is a chronic infectious disease primarily affecting the skin and peripheral nerves and is caused by Mycobacterium leprae. Although effective control measures have significantly reduced its global incidence in recent years, its insidious onset and diverse skin manifestations pose considerable challenges to early diagnosis, particularly among young medical practitioners. This study reports a case of tuberculoid leprosy accompanied by a type I reaction (T1R) to leprosy, aiming to contribute to the broader understanding and management of the disease. The patient came from a leprosy-endemic region and had a family history of leprosy. They first presented with neuritis, characterised by numbness in the left upper limb, which is an early-stage symptom often overlooked. This case accentuates the importance of comprehensive examination techniques, including bacteriological and histological investigations, ultrasound and magnetic resonance imaging, to identify early nerve damage, which is critical for prompt diagnosis and intervention. According to World Health Organization data, approximately 200,000 new cases of leprosy are reported worldwide each year, with a prevalence rate of 0.2 cases per 10,000 individuals. The disease exhibits two clinical forms based on the host's immune response: tuberculoid leprosy in a well-immunised population and lepromatous leprosy in a poorly immunised host. The patient in this study demonstrated signs of tuberculoid leprosy, marked by isolated skin papules and plaques, and a T1R, a tissue-destructive, immune-driven inflammatory process. This case underscores the need for ongoing education and updated diagnostic tools to facilitate the early detection of leprosy, particularly in endemic areas. Moreover, attention must be given to the comprehensive care of patients, encompassing both physical and psychological aspects, to improve their quality of life and mitigate social discrimination and prejudice.
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Affiliation(s)
- Jie Li
- Department of Dermatology, GuiQian International General Hospital, Guiyang, Guizhou, 550018, People’s Republic of China
| | - Chun-Hong Wang
- Department of Dermatology, The Affiliated Hospital of Guizhou University, Guiyang, Guizhou, 550001, People’s Republic of China
| | - De-Hou Yu
- Department of Dermatology, The Affiliated Hospital of Guizhou University, Guiyang, Guizhou, 550001, People’s Republic of China
| | - Qin He
- Department of Dermatology, The Affiliated Hospital of Guizhou University, Guiyang, Guizhou, 550001, People’s Republic of China
| | - Wei He
- Department of Dermatology, GuiQian International General Hospital, Guiyang, Guizhou, 550018, People’s Republic of China
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Dutta Majumder P, Mochizuki M, González-López JJ, Gonzales J, Sharma M, Sharma K, Biswas J. Laboratory Investigations in Infectious Uveitis. Ocul Immunol Inflamm 2023; 31:1405-1415. [PMID: 36698066 DOI: 10.1080/09273948.2022.2164728] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 12/07/2022] [Accepted: 12/13/2022] [Indexed: 01/27/2023]
Abstract
Laboratory investigations can play a significant role in the diagnosis and decision-making of infectious uveitis. Though direct demonstration of the infective organism remains the gold standard of diagnosis, it is not always possible with ocular tissues. Recent advancements in molecular techniques have made it possible to overcome these limitations and to identify the genomic DNA of pathogens associated with infectious uveitis. Techniques such as next-generation sequencing can analyze all DNA-based lifeforms, regardless of whether they are bacteria, fungi, viruses, or parasites and have been used in the laboratory diagnosis of intraocular inflammation. On the other hand, serological tests, though they dominate the diagnostic landscape of various infectious etiologies in uveitis in routine clinical practice, have varied specificities and sensitivities in different infectious uveitis. In this review, we focus on various methods of laboratory diagnosis of infectious uveitis and discuss the recent advances in molecular diagnosis and their role in various infectious clinical entities.
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Affiliation(s)
| | - Manabu Mochizuki
- Miyata Eye Hospital, Miyakonojo, Japan
- Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Julio J González-López
- Ophthalmology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Surgery Department, Universidad de Alcalá, Madrid, Spain
| | - John Gonzales
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
- Department of Ophthalmology, University of California, San Francisco, California, USA
| | - Megha Sharma
- Department of Microbiology, All India Institute of Medical Sciences, Bilaspur, India
| | - Kusum Sharma
- Department of Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh (PGIMER), Chandigarh, India
| | - Jyotirmay Biswas
- Director of Uveitis & Ocular Pathology, Sankara Nethralaya, Chennai, India
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Zhang Y, Feng L, Wang L. Leprosy: A Life-Changing Disease. J Eur Acad Dermatol Venereol 2022; 36:e695-e697. [PMID: 35412695 DOI: 10.1111/jdv.18144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/11/2022] [Accepted: 03/31/2022] [Indexed: 02/05/2023]
Affiliation(s)
- Ying Zhang
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China.,Department of Dermatology, Chongqing Hospital of Chinese Medicine, Chongqing, China
| | - Lin Feng
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China.,Department of Dermatology, Chongqing Hospital of Chinese Medicine, Chongqing, China
| | - Lin Wang
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, China
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