Leprosy classification methods: A comparative study in a referral center in Brazil

Global Medical Microbiology Summit & Expo

November 28-29, 2016 San Francisco, USA

Ismael Alves Rodrigues Junior and Rosa Maria Esteves Arantes

Universidade Federal de Minas Gerais, Brazil

Posters & Accepted Abstracts: J Med Microb Diagn

Abstract :

We first faced particularities of leprosy classification methods while working on the correlation between the degree of thermal sensitivity impairment of leprosy cutaneous lesions, measured by quantitative sensory test and the degree of lesions denervation, evaluated by immunohistochemistry anti-PGP 9.5. WHO operational classification (WOC) differentiates patients in paucibacillary (up to five skin lesions) and multibacillary (six or more lesions) and is the one used in the field. The Ridley and Jopling classification (RJC) differentiates patients according to their clinical, histopathological, bacteriological and immunological presentation and is the most widely used scientific classification. Different authors have pointed out that many multibacillary RJC patients are misclassified as paucibacillary by WOC. This may result in inadequate treatment duration, underestimation of the sequelae risk and difficulty for the epidemiological control. On the other hand, different authors have shown considerable disagreement between RJC clinical and histological components. In consonance with the literature, our data showed that WOC overestimated the number of multibacillary patients (42.9% vs. 36.8%) but also classified as paucibacillary 28.6% of the RJC multibacillary patients. The slit-skin smear bacilloscopy, currently out of �WHO� recommendations, reclassified as multibacillary 14.8% of the WOC paucibacillary patients and as paucibacillary 42.8% of the WOC multibacillary patients. As for the clinical and histopathological components of RJC, the agreement was perfect in 46.9% of the sample. The most delicate aspects were the histopathological differentiation between the tuberculoid and borderline-tuberculoid forms and the histopathological classification of the mid-borderline form. It seems that these issues arise from RJC histopathological criteria flaws.

Biography :

Email: ismaelalvesrodrigues@gmail.com