Degree of skin denervation and its correlation to objective thermal sensory test in leprosy patients.
BACKGROUND: Leprosy is an infectious disease affecting skin and peripheral nerves resulting in increased morbidity and physical deformities. Early diagnosis provides opportune treatment and reduces its complications, relying fundamentally on the demonstration of impaired sensation in suggestive cuta...
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ftdoajarticles:oai:doaj.org/article:be8e57248c0b4f89ae54f5bde638e777 2023-05-15T15:16:40+02:00 Degree of skin denervation and its correlation to objective thermal sensory test in leprosy patients. Ismael Alves Rodrigues Júnior Isabel Cristina Costa Silva Letícia Trivellato Gresta Sandra Lyon Manoel de Figueiredo Villarroel Rosa Maria Esteves Arantes 2012-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0001975 https://doaj.org/article/be8e57248c0b4f89ae54f5bde638e777 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3521713?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001975 https://doaj.org/article/be8e57248c0b4f89ae54f5bde638e777 PLoS Neglected Tropical Diseases, Vol 6, Iss 12, p e1975 (2012) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2012 ftdoajarticles https://doi.org/10.1371/journal.pntd.0001975 2022-12-30T23:01:07Z BACKGROUND: Leprosy is an infectious disease affecting skin and peripheral nerves resulting in increased morbidity and physical deformities. Early diagnosis provides opportune treatment and reduces its complications, relying fundamentally on the demonstration of impaired sensation in suggestive cutaneous lesions. The loss of tactile sensitivity in the lesions is preceded by the loss of thermal sensitivity, stressing the importance of the thermal test in the suspicious lesions approach. The gold-standard method for the assessment of thermal sensitivity is the quantitative sensory test (QST). Morphological study may be an alternative approach to access the thin nerve fibers responsible for thermal sensitivity transduction. The few studies reported in leprosy patients pointed out a rarefaction of thin dermo-epidermal fibers in lesions, but used semi-quantitative evaluation methods. METHODOLOGY/PRINCIPAL FINDINGS: This work aimed to study the correlation between the degree of thermal sensitivity impairment measured by QST and the degree of denervation in leprosy skin lesions, evaluated by immunohistochemistry anti-PGP 9.5 and morphometry. Twenty-two patients were included. There were significant differences in skin thermal thresholds among lesions and contralateral skin (cold, warm, cold induced pain and heat induced pain). The mean reduction in the density of intraepidermal and subepidermal fibers in lesions was 79.5% (SD = 19.6) and 80.8% (SD = 24.9), respectively. CONCLUSIONS/SIGNIFICANCE: We observed a good correlation between intraepidermal and subepidermal fibers deficit, but no correlation between these variables and those accounting for the degree of impairment in thermal thresholds, since the thin fibers rarefaction was homogeneously intense in all patients, regardless of the degree of sensory deficit. We believe that the homogeneously intense denervation in leprosy lesions should be objective of further investigations focused on its diagnostic applicability, particularly in selected cases with only ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 6 12 e1975 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Ismael Alves Rodrigues Júnior Isabel Cristina Costa Silva Letícia Trivellato Gresta Sandra Lyon Manoel de Figueiredo Villarroel Rosa Maria Esteves Arantes Degree of skin denervation and its correlation to objective thermal sensory test in leprosy patients. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND: Leprosy is an infectious disease affecting skin and peripheral nerves resulting in increased morbidity and physical deformities. Early diagnosis provides opportune treatment and reduces its complications, relying fundamentally on the demonstration of impaired sensation in suggestive cutaneous lesions. The loss of tactile sensitivity in the lesions is preceded by the loss of thermal sensitivity, stressing the importance of the thermal test in the suspicious lesions approach. The gold-standard method for the assessment of thermal sensitivity is the quantitative sensory test (QST). Morphological study may be an alternative approach to access the thin nerve fibers responsible for thermal sensitivity transduction. The few studies reported in leprosy patients pointed out a rarefaction of thin dermo-epidermal fibers in lesions, but used semi-quantitative evaluation methods. METHODOLOGY/PRINCIPAL FINDINGS: This work aimed to study the correlation between the degree of thermal sensitivity impairment measured by QST and the degree of denervation in leprosy skin lesions, evaluated by immunohistochemistry anti-PGP 9.5 and morphometry. Twenty-two patients were included. There were significant differences in skin thermal thresholds among lesions and contralateral skin (cold, warm, cold induced pain and heat induced pain). The mean reduction in the density of intraepidermal and subepidermal fibers in lesions was 79.5% (SD = 19.6) and 80.8% (SD = 24.9), respectively. CONCLUSIONS/SIGNIFICANCE: We observed a good correlation between intraepidermal and subepidermal fibers deficit, but no correlation between these variables and those accounting for the degree of impairment in thermal thresholds, since the thin fibers rarefaction was homogeneously intense in all patients, regardless of the degree of sensory deficit. We believe that the homogeneously intense denervation in leprosy lesions should be objective of further investigations focused on its diagnostic applicability, particularly in selected cases with only ... |
format |
Article in Journal/Newspaper |
author |
Ismael Alves Rodrigues Júnior Isabel Cristina Costa Silva Letícia Trivellato Gresta Sandra Lyon Manoel de Figueiredo Villarroel Rosa Maria Esteves Arantes |
author_facet |
Ismael Alves Rodrigues Júnior Isabel Cristina Costa Silva Letícia Trivellato Gresta Sandra Lyon Manoel de Figueiredo Villarroel Rosa Maria Esteves Arantes |
author_sort |
Ismael Alves Rodrigues Júnior |
title |
Degree of skin denervation and its correlation to objective thermal sensory test in leprosy patients. |
title_short |
Degree of skin denervation and its correlation to objective thermal sensory test in leprosy patients. |
title_full |
Degree of skin denervation and its correlation to objective thermal sensory test in leprosy patients. |
title_fullStr |
Degree of skin denervation and its correlation to objective thermal sensory test in leprosy patients. |
title_full_unstemmed |
Degree of skin denervation and its correlation to objective thermal sensory test in leprosy patients. |
title_sort |
degree of skin denervation and its correlation to objective thermal sensory test in leprosy patients. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2012 |
url |
https://doi.org/10.1371/journal.pntd.0001975 https://doaj.org/article/be8e57248c0b4f89ae54f5bde638e777 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 6, Iss 12, p e1975 (2012) |
op_relation |
http://europepmc.org/articles/PMC3521713?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001975 https://doaj.org/article/be8e57248c0b4f89ae54f5bde638e777 |
op_doi |
https://doi.org/10.1371/journal.pntd.0001975 |
container_title |
PLoS Neglected Tropical Diseases |
container_volume |
6 |
container_issue |
12 |
container_start_page |
e1975 |
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1766346964472954880 |