Hansen's neuritis revisited – A clinicopathological study
2018
Introduction: Leprosy affecting the nerve solely or with concomitant skin
lesions is not an uncommon condition in clinical practice. It is responsible
for extensive morbidity and often poses a diagnostic challenge. This study
aims to highlight the clinicopathological features of Hansen’s neuritis (HN).
Materials and Methods: In this retrospective study, cases of histologically
diagnosed HN, from January 2010 to July 2017, were reviewed in the light of
clinical features, treatment history, and outcome. Results: There were 18 cases of
HN which accounted for 3.97% of total nerve biopsy samples (n = 453) and 0.02%
of total histopathology samples (n = 81,013). The male: female ratio was 5:1 in the
cases of HN. Age range was 20–79 years with a mean age of 42.4 years (standard
deviation: ±14.03). Among the HN cases, there were 13 cases of pure neuritic
leprosy (61.1%). Mononeuritis multiplex was the most common finding in the
nerve conduction study. Six (33.3%) cases exhibited histological features of
borderline tuberculoid leprosy, followed by five (27.8%) cases of mid‑borderline
features, three (16.7%) cases each of borderline lepromatous and burnt‑out HN,
and one (5.6%) case of polar tuberculoid leprosy. Lepra bacilli were detected
on Fite‑Faraco stain in 44.4% cases. Conclusion: Diagnosis of HN depends on
astute search for skin lesions, nerve thickening or tenderness, sensory or motor
symptoms, histopathological examination, and demonstration of lepra bacilli.
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