<\/span><\/h2>\nLeprosy is a chronic<\/span> infection<\/span> caused by Mycobacterium leprae<\/em>, a must intracellular<\/span>, Gram positive organism<\/span>. The main clinical types correlate with a specific histopathological pattern.<\/p>\n<\/span>\nHistology<\/span> of leprosy<\/span><\/h2>\nLepromatous leprosy: below normal epidermis<\/span> and grenz zone<\/span>, there are sheets or groups of macrophages<\/span> (Figure 1). Macrophages are abundant pink to pale in color. cytoplasm<\/span> which corresponds to numerous intracellular (parasitized) organisms<\/span> (Figure 2). The Associated infiltrate<\/span> is generally scarce and mainly lymphocytic<\/span>. In older lesions, macrophages may have bubbling cytoplasm (Figure 2). Unlike tuberculoid leprosy, there are no well-formed granulomas<\/span> or infiltration<\/span> of nerves<\/span>.<\/p>\nTuberculoid leprosy: there is a tuberculoid or sarcoid granulomatous<\/span> reaction throughout dermis<\/span> consisting of some Langhans giant cells<\/span>, macrophages in tight groups, and few companions lymphocytes<\/span> (figure 3). The infiltrate can infiltrate widely peripheral<\/span> nerves (figure 4, arrow), vessels, overlying epidermis and arrectores pilorum.<\/p>\nIndeterminate leprosy: the infiltrate is strongly lymphocytic with a smaller number of epithelioid<\/span> histiocytes<\/span> in clusters The infiltrate often involves peripheral nerves. The organisms are usually very difficult to find.<\/p>\nErythema<\/span> leprous nodosum: shows a dense infiltrate that extends towards the subcutis<\/span>, particularly around the vasculature. In addition to the epithelioid histiocytes with large bubbly pink cytoplasm seen in other clinical types, there is a polymorphous<\/span> population of acute<\/span> and chronic inflammatory<\/span> cells.<\/p>\n\n<\/span>Leprosy pathology<\/span><\/h5>\n<\/section>\n\n\n
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Figure 1<\/p>\n
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Figure 2<\/p>\n
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figure 3<\/p>\n
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Figure 4<\/p>\n<\/p><\/div>\n<\/section>\n
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<\/span>Special studies for leprosy.<\/span><\/h2>\nLeprosy organisms can be demonstrated with a modified Ziehl-Neelsen (Wade-Fite) stain. Lepromatous leprosy lesions will show numerous organisms that are easy to identify. Cases of tuberculoid, indeterminate, and erythema nodosum leprosum can be difficult as the organisms may be rare. Polymerase chain reaction<\/span> (PCR<\/span>) studies may be useful in confirming the diagnosis of leprosy.<\/p>\n<\/span>\nDifferential diagnosis<\/span> of leprosy pathology<\/span>
\n<\/span><\/h2>\nGranulomatous disorders: Tuberculoid leprosy may resemble sarcoidosis or other granulomatous disorders. Special studies and clinical correlation can help in difficult cases.<\/p>\n
Histiocytic<\/span> reactions: the foamy histiocytes, laden with organisms in lepromatous leprosy, can mimic the histiocytic reactions seen with statement<\/span> aluminum chloride (a common antiperspirant and hemostatic agent) or orthopedic<\/span> hardware.<\/p>\nTuberculosis and other mycobacterial infections: Other mycobacterial infections often cause tissue necrosis<\/span> and are associated with suppuration. M. avium<\/em> complex can closely mimic lepromatous leprosy. Special studies can help in the differential.<\/p>\nLymphoma<\/span> – T cell<\/span> Lymphomas may be neurotropic and associated with scattered histiocytes, producing a pattern similar to indeterminate leprosy. Sometimes special studies are needed to reveal a T cell clone and\/or isolate the organisms.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"Introducci\u00f3n La lepra es un cr\u00f3nico infecci\u00f3n causado por Mycobacterium leprae, un obligado intracelular, Gram positivas organismo. Los principales tipos cl\u00ednicos se correlacionan con un patr\u00f3n histopatol\u00f3gico espec\u00edfico. Histolog\u00eda de…<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[205],"class_list":["post-16620","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones","tag-patologia"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/16620","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=16620"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/16620\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=16620"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=16620"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=16620"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}