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References in periodicals archive ?
This finding is comparable with the study of Niranjana Moorthy et al, where overall concordance was seen in 62.63% of cases with maximum concordance in the diagnosis of polar lepromatous Hansen's disease (80%).
In moving from polar tuberculoid to polar lepromatous leprosy one finds a sharp increase in the prevalence of leprous lesions in the liver.
Leprosy is a chronic granulomatous infection with permanent consequences which is caused by Mycobacterium leprae and primarily involves skin and nerves.1 Clinically leprosy presents as a spectrum of manifestations consisting of two constant poles from polar tuberculoid (TT) to polar lepromatous (LL) disease.
(19) Furthermore, in what was at that time a controversial therapeutic leap, the director of the leprosarium at Sugai Buloh, Bhojwani, discontinued dapsone monotherapy in 362 polar lepromatous and borderline lepromatous patients who had been treated for 18-5 to 22 years and were for several consecutive years skin smear negative.
Including the variables in the Cox regression model, we found that only three factors were associated with the occurrence of relapses in the cohort: initial BI [greater than or equal to] 2-0, history of antireactional treatment and polar lepromatous leprosy as clinical type.
In turn characteristics that best predict the occurrence of relapse obtained by Cox regression model are: initial BI [greater than or equal to] 2.0, and antireaccional treatment history and clinical classification as polar lepromatous leprosy.
(29) The higher frequency of reactions in this cohort could be explained by the predominance of polar lepromatous leprosy patients (69%) with high bacillary loads; other possible explanations for these differences are: (i) population genetic differences, (ii) differences in the criteria for diagnosis of reactions, (iii) differences in the training of observers: dermatologists and dermatology residents in a specialised centre for evaluation versus general practitioners and other health personnel in field studies.
(19) A relatively apolar glycolipid (called I) was identified in skin samples from high bacillary index (BI, a measure of the number of acid fast bacilli found in the dermis, usually the average from up to six biopsy sites, based on a logarithmic scale from 0 at the polar tuberculoid end to 6 + at the polar lepromatous side of the clinical leprosy spectrum) lepromatous leprosy patients, absent from normal skin samples and a collection of cultivable mycobacteria, but present in armadillo-derived purified M.
(38) The levels of PGL-I in the serum correlated with the BI, with the highest levels detected in multibacillary (MB) individuals with diffuse skin infiltration and skin nodules, and polar lepromatous individuals with a BI > 5 0, concentrations which ranged from 1 to 32 [micro]g of PGL-I per ml.
The clinical manifestations of leprosy form a continuum extending from polar tuberculoid to polar lepromatous leprosy.