Assessment of Clinical, Histopathological, and Bacteriological Findings in Treated Leprosy Patients with Persistent Skin Lesions: A Retrospective Cohort Study

Meenakshi Patial Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;

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Vinod Hanumanthu Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;

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Seema Chhabra Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;

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Itu Singh The Leprosy Mission, Stanley Browne Research Laboratory, New Delhi, India;

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Debajyoti Chatterjee Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

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Tarun Narang Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;

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Sunil Dogra Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;

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ABSTRACT.

Since the introduction of multidrug therapy (MDT), various disabilities/morbidities due to leprosy have been prevented. However, there is a subset of patients in whom the skin lesions do not resolve completely or remain unchanged despite a full course of MDT, which is a great source of anxiety to the patient and their family members. Hence, we tried to ascertain the putative causes and risk factors of persistent skin lesions (PSLs) by analyzing the clinical, histopathological, bacteriological, and drug resistance patterns. This is a retrospective, cohort study wherein 35 patients who had PSLs after completion of MDT were included. The majority of the patients were 18 to 30 years of age, with males predominating. Borderline tuberculoid leprosy was the most common clinical spectrum observed (71.4%). The majority had PSLs distributed predominantly over photo-exposed sites (upper limbs > trunk > face). Eight patients (22.8%) had a history of contact with leprosy patients in their family, and six patients (17.1%) had associated comorbidities. Improvement in histopathological parameters such as a decrease in granuloma fraction was observed in 22 patients (62.8%) with PSLs after release from treatment in comparison with baseline. Four patients (11.4%) were noted to have drug resistance (three to rifampicin and one to dapsone). Thus, our study emphasizes that leprosy patients with PSLs after completion of MDT should undergo histopathological evaluation and drug resistance studies.

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Author Notes

Authors’ addresses: Meenakshi Patial, Vinod Hanumanthu, Tarun Narang, and Sunil Dogra, Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India, E-mails: meenakshi.patial7@gmail.com, drvinodh15@gmail.com, narangtarun@yahoo.co.in, and sundogra@hotmail.com. Seema Chhabra, Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India, E-mail: drseemachhabra@gmail.com. Itu Singh, The Leprosy Mission, Stanley Browne Research Laboratory, New Delhi, India, E-mail: itusingh@gmail.com. Debajyoti Chatterjee, Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India, E-mail: devchat1984@gmail.com.

Address correspondence to Tarun Narang, Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. E-mail: narangtarun@yahoo.co.in
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