Sensitive Damage in Leprosy: A Longitudinal and Retrospective Study

A. Castanheira, S. Bandeira, A. Chichester, A. L. Reis, C. Nascimento, Caroline da Silva Alves Palheta, W. Loureiro, F. Carneiro, C. Pires
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Abstract

Background: The evaluation of leprosy patients requires a careful dermatological and neurological examination in order to monitor the possible damage to the peripheral nerves. This study focused on evaluate the sensitivity at the time of diagnosis and discharge of leprosy patients from Dermatology Department of the State University of the State of Para.   Methods and Findings: this is a longitudinal, retrospective and descriptive study based on medical records that presented neurological assessment and degree of physical disability of 30 patients assisted at a referral service between 2016 and 2019, applying descriptive statistical analysis. Concerning neural involvement, 88.89% of the patients with neural damage were male, 100% of patients in this group were multibacillary (p-value: 0.02), 42.8% were borderliners (p-value: 0.04), 88.8% had some type of leprosy reaction (p-value: 0.02) and 44.4% of the patients had a diagnosis of leprosy with more than one year of disease evolution; most patients with neural involvement (N = 16) had more than one nerve affected, with the right tibial nerve being the most affected (24.14%); It was noted that a considerable portion of multibacillary patients did not improve or worsened (75%), and the borderline form was the one with the worst prognosis, showing 50% of patients did not respond to treatment. Conclusions: Most of the patients with neural damage were multibacillary, and borderliners, with many of those without presenting improvement, or showing worsening of clinical condition after multidrug therapy. Thus, it is highlighted the primary role of longitudinal assessment of those patients, in view of the possibility of chronification and sequel development.
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麻风的敏感性损害:一项纵向和回顾性研究
背景:麻风病患者的评估需要仔细的皮肤科和神经科检查,以监测周围神经可能受到的损伤。本研究的重点是评估帕拉州州立大学皮肤科麻风患者在诊断和出院时的敏感性。方法和发现:这是一项基于医疗记录的纵向、回顾性和描述性研究,采用描述性统计分析,对2016年至2019年间接受转诊服务的30名患者进行了神经评估和身体残疾程度。在神经受累方面,88.89%的神经损伤患者为男性,该组患者中100%为多发性(p值:0.02),42.8%为无边界者(p值为0.04),88.8%有某种类型的麻风病反应(p值是0.02),44.4%的患者诊断为麻风病并有一年以上的疾病演变;大多数神经受累患者(N=16)有一条以上神经受累,其中右胫神经受累最多(24.14%);值得注意的是,相当一部分多乳头患者没有改善或恶化(75%),临界型是预后最差的一种,显示50%的患者对治疗没有反应。结论:大多数神经损伤患者都是多发性和边缘型患者,其中许多患者在多药治疗后没有改善,或临床状况恶化。因此,鉴于慢性化和后续发展的可能性,强调了对这些患者进行纵向评估的主要作用。
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