BACKGROUND: The diversity of clinical manifestations of leprosy has given rise to different classification systems. However, there are important differences in the sensitivity and specificity of these classifications. The objective of this study was to evaluate the agreement between clinical and histopathological data for classifying leprosy. METHODS: A total of 1265 patient reports containing clinical and histopathological data relating to the diagnosis and classification of leprosy were included in this study. The diagnostic concordance between the clinical form (Madrid classification) and the histopathological type, as well as the initial and final classifications, was calculated by dividing the number of concordant cases by the total number of patients. RESULTS: The overall agreement between the World Health Organization operational classification and the results of direct smear examination of the lesion for acid-fast bacilli was 84.8% (1073/1265). The clinical-histopathological agreement was 58.1% (735/1265). The indeterminate and lepromatous forms were those that showed the highest percentages of agreement: 72.1% (186/258) and 71.0% (142/200), respectively. CONCLUSION: Although classifications based on clinical characteristics have an important role in the control of leprosy, they present flaws that can influence the adequacy of treatment. Therefore, a histopathological examination is important for appropriate treatment.
BACKGROUND: The diversity of clinical manifestations of leprosy has given rise to different classification systems. However, there are important differences in the sensitivity and specificity of these classifications. The objective of this study was to evaluate the agreement between clinical and histopathological data for classifying leprosy. METHODS: A total of 1265 patient reports containing clinical and histopathological data relating to the diagnosis and classification of leprosy were included in this study. The diagnostic concordance between the clinical form (Madrid classification) and the histopathological type, as well as the initial and final classifications, was calculated by dividing the number of concordant cases by the total number of patients. RESULTS: The overall agreement between the World Health Organization operational classification and the results of direct smear examination of the lesion for acid-fast bacilli was 84.8% (1073/1265). The clinical-histopathological agreement was 58.1% (735/1265). The indeterminate and lepromatous forms were those that showed the highest percentages of agreement: 72.1% (186/258) and 71.0% (142/200), respectively. CONCLUSION: Although classifications based on clinical characteristics have an important role in the control of leprosy, they present flaws that can influence the adequacy of treatment. Therefore, a histopathological examination is important for appropriate treatment.
Authors: Lucrecia Acosta Soto; Nelson Caballero; Lesny Ruth Fuentes; Pedro Torres Muñoz; Jose Ramón Gómez Echevarría; Montserrat Pérez López; Fernando Jorge Bornay Llinares; John L Stanford; Cynthia A Stanford; Helen D Donoghue Journal: Am J Trop Med Hyg Date: 2017-10 Impact factor: 2.345
Authors: Wen Yan; Yan Xing; Lian Chao Yuan; Rong De Yang; Fu Yue Tan; Ying Zhang; Huan-Ying Li Journal: Am J Trop Med Hyg Date: 2014-02-03 Impact factor: 2.345
Authors: Victor S Santos; Laudice S Oliveira; Fabrícia D N Castro; Vanessa T Gois-Santos; Ligia M D Lemos; Maria do C O Ribeiro; Luis E Cuevas; Ricardo Q Gurgel Journal: PLoS Negl Trop Dis Date: 2015-07-01
Authors: Edessa Negera; Stephen L Walker; Selfu Girma; Shimelis N Doni; Degafe Tsegaye; Saba M Lambert; Munir H Idriss; Yohanis Tsegay; Hazel M Dockrell; Abraham Aseffa; Diana N Lockwood Journal: PLoS Negl Trop Dis Date: 2017-10-13