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Neuritic Leprosy (neuritic + leprosy)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

The development of cutaneous lesions during follow-up of patients with primary neuritic leprosy

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2005
Sujai Suneetha PhD
Background, Primary neuritic leprosy (PNL) is a rare form of leprosy where the characteristic skin lesions are absent. Investigations of apparently normal skin from the areas of sensory change have revealed microscopic evidence of nerve involvement. Clinical studies have found that a proportion of patients develop visible skin lesions during follow-up. The aim of the study was to perform a clinical and histological analysis of PNL patients who developed visible skin lesions during treatment and follow-up, to gain insight into the pathogenesis of the disease. Methods, Twenty-nine individuals in a series of 182 PNL patients developed visible skin lesions during follow-up. Analysis of the number, location, histology and time of onset of the new skin lesions in relation to the type and regularity of the treatment regimen were noted. A biopsy from the new skin lesion when available was compared with the nerve biopsy findings at the time of initial diagnosis. Results, Thirty-eight per cent of patients developed a single patch and 28% developed two patches. Over three-quarters of these were on the lower limb (47%) or the upper limb (29%). Sixty-two per cent of patients developed the lesions within 2 years of the onset of symptoms. Patients on regular treatment developed patches earlier than those on irregular treatment or no treatment. A skin biopsy from the new patch revealed borderline tuberculoid leprosy histology in 47% of the patients. Conclusions, The findings suggest that leprosy primarily affects the nerve and that a neuritic phase precedes the development of visible cutaneous lesions. [source]

Expression of metalloproteinases (MMP-2, MMP-9, and TACE) and TNF-, in the nerves of leprosy patients

JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 3 2007
Rosane M. B. Teles
Abstract Matrix metalloproteinases (MMPs) and tumor necrosis factor alpha (TNF-,) play important and related roles in the pathogenesis of nerve injury. MMP-dependent and TNF-,-dependent processes of neurodegeneration, such as blood-nerve breakdown and immune cell recruitment, are characteristic of leprosy nerve damage. Our work has contributed to the understanding of the role of cytokines in the process, but the role of MMPs in the pathogenesis of neuritic leprosy has not been investigated. This study analyzed the changes in mRNA expression and immunodistribution of MMP-2, MMP-9, TNF-,-converting enzyme (TACE), TNF-, in nerves of 27 pure neuritic leprosy (PNL) patients, both acid-fast bacilli positive (AFB+) and acid-fast bacilli negative (AFB,), and 8 non-leprosy patients with control peripheral neuropathic conditions. MMP-2, MMP-9, and TNF-, mRNA expression was significantly induced in the AFB, relative to the AFB+ neuritic leprosy group and nonlepritic controls; TACE levels were also elevated in the AFB, group, but this change was not statistically significant. Immunoreactive profiles for TNF-, and MMPs demonstrated strong reactivity of myelinated axons, infiltrating macrophages, Schwann cells, endothelial cells, and perineurial cells in neuritic leprosy biopsies. This study provides the evidence of the involvement of MMPs in the pathogenesis of PNL neuropathy. [source]