Leprosy
Mailing List – March 28th, 2010
Ref.: Indeterminate
(I) leprosy
From: Grace
Warren,
Sidney
,
Australia
Dear
Salvatore,
Indeterminate
leprosy is the very earliest form of leprosy in which the first signs
of inflammation are evident but, the disease is only just becoming
established. By the time
the first indefinite vague edged lesions can be seen there is still
only mild inflammation in
the tissues and many good pathologists are even hesitant to make a
diagnosis on the pathology. Which
from the name is still INDETERMINED as to which type of disease is
developing. In fact a
number of senior pathologists will only make a positive diagnosis if
they detect some acid fast bacilli (AFB) in the biopsy.
A
slit skin smear examination rarely shows the bacilli which are
relatively rare. If
bacilli are easily found
in a slit skin smear it is already determined.
In
Indeterminate leprosy the earliest lesions are merely dyschromic. They
can be pinkish is a true light skin or light in colour on a
pigmented skin. They do
not hurt and there is no detectable sensory abnormality or pain or
itch. There may be one
only or many lesions.
Diagnosis
is often a result of suspicion and every dyschromic lesion in an
endemic area should be looked at carefully.
The whole body must be examined and all nerves palpated; though
if any nerve is enlarged it would probably cancel indeterminate.
A
biopsy may show some inflammation but, as said before, if AFB cannot
be found a positive diagnosis of leprosy
cannot be made.
Grace
