ABSTRACT
Introduction: Leprosy is a chronic granulomatous disease presents variedly depending on the patient's immune status at the time of infection. In this study, we are planning to perform a retrospective analysis to characterise the trend of Lepromatous spectrum of Hansen's disease cases registered in Tertiary care centre. To analyse the incidence,Aim: clinical patterns and variants of Lepromatous spectrum of Hansen's disease cases registered in Tertiary care centre. Objectives: To describe the epidemiological trend of Lepromatous Spectrum of Hansen's Disease and its clinical variants. A Retrospective observational study involving Lepromatous spectrum of Hansen's diseaseMethodology cases registered in leprosy clinic in last 5 years (2017-2021). Patient demographic details, duration of disease, clinical presentations , investigation details like slit skin smear, biopsy reports, treatment data was extracted from the Leprosy case register and data analysis was done in this study. 129 leprosy patients (BL-69, LL-43, Histoid-15, PureResults neuritic-2) reported during the period of 2017 to 2021[ 5 years]. 2018and 2019 had maximum number of cases approximately 30 new cases of leoromatous leprosy . Hypopigmented patches and glove & stocking anaesthesia seen in 59.8% cases, skin nodules seen in 45.7%, earlobe infiltration seen in 21.7%, epistaxis &saddle nose deformity seen in 4.3%, gynaecomastia seen in 2.2%, trophic ulcer seen in 26.1% at the time of presentation mainly involving the foot followed by hands, only nerve involvement without skin lesion present in 1.1% of cases. Claw hand was the most common deformity witnessed . The presence of Wartenberg sign was observed in 10 patients. Apart from ulnar and common peroneal nerve involvement present in 100 %of the patients, other peripheral nerves were involved in significant number of patients.All these patients showed positive acid fast bacilli in slit skin smear . Active surveillanceConclusion and early detection of the disease are imperative to prevent the spread of M. leprae. It is essential for timely implementation of treatment which will prevent deformities and disabilities. Active case detection plays the major role in early diagnosis of leprosy.
ABSTRACT
There is a complete lack of data on clinico epidemiological profile of pure neurotic leprosy from Western Odisha region, despite the area still being endemic for leprosy. This study has been carried out to address this issue to identify the profile of pure neuritic leprosy reporting to a Tertiary Care Centre in Western Odisha. Patient's case records with clinical diagnosis of PNL who reported to this centre between October 2012 to October 2014 were studied. Demographic details, educational qualification, clinical presentation, pattern of peripheral nerve involvement, type of disabilities and complications occurring if any, were noted from the patient records and analyzed. Data collected and analysed shows that out of total 1460 of these leprosy patients 145 (9.93%) patients had been diagnosed with pure neuritic form of the disease. The mean age of PNL patients was 34.43 + 1.09 years. The various clinical presentations, that were observed and recorded, included sensory loss, tingling, pain, hypoesthesia, trophic ulcer and various grades of motor nerve disabilities. Neuropathic pain was complained by 28.3% patients. Mononeuritic presentation was observed in 79/145 (54.5%) patients with ulnar nerve being the most commonest nerve involved. Grade 2 disabilities were present in a large proportion of these PNL cases. Disabilities were more common in polyneuritic type of cases compared with mononeuritic cases. Such high disability rates in these PNL cases at our Tertiary Care Centre might be due to late self reporting of cases for treatment or diagnosis being delayed. These figures may not reflect the proportion/percentages at population level which should be verified by actual surveys after proper training of staff. As PNL demands early diagnosis to prevent progression of nerve damage and multiple nerve involvement, all patients having the above clinical presentations should be suspected of PNL in leprosy endemic areas