Sensitive Damage in Leprosy: A Longitudinal and Retrospective Study

2020 
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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