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LEPROSY

Skin Hands MRI: Nerve Roots Nerve Pathology Ultrastructure

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Leprosy: Skin

From: A Sabouri Pre-Treatment

From: A Sabouri Post-Treatment

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From: A Sabouri

From: M Al-Lozi Skin: Hypopigmented lesion

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Leprosy: Hands

From: A Sabouri

From: A Sabouri

From: A Sabouri

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Leprosy: Nerve Root Enlargement

From: A Sabouri

Proximal C7 nerve roots: Large bilaterally, right greater left

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C8 & T1 nerve roots: Large on right

From: A Sabouri

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Leprosy: Nerve Pathology

• Nerves often biopsied
  • Ulnar: Cutaneous dorsalis branch
  • Sural
• Patterns of involvement
  • Asymmetric: Differential involvement among fascicles
  • Endoneuritis, mononuclear cell
  • Granulomas, epithelioid
  • Fibrosis
    • Fascicular: Tuberculoid leprosy; Chronic disease
    • Perineurial: Chronic disease
  • Lepromatous leprosy
• Diagnosis
  • M leprae detected (10%)
  • qPCR+ (34%)
  • qPCR on adjacent skin (25%)

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Tuberculoid Leprosy: Nerve Pathology

Multiple fascicles with no endoneurial structure

From: R Schmidt

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Fascicle replaced by granulomatous structure (Arrow)

From: R Schmidt

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From: R Schmidt

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Lepromatous Leprosy: Nerve Pathology

Inflammation: Perimysial & Pervascular

From: R Schmidt

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Leprosy: Ultrastructure

From: R Schmidt

Endoneurium: Organisms wihin Histiocytes

From: R Schmidt

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Nerve biopsy: Intracellular M. leprae Electron micrographs: From Dennis K Burns MD Return to Leprosy 12/14/2024