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    Evaluation of polymerase chain reaction in nerve biopsy specimens of patients with Hansen's disease.
    J Neurol Sci 2017 Sep 27;380:187-190. Epub 2017 Jul 27.
    Department of Neurology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India. Electronic address:
    Background: Pure neuritic variety of leprosy (PNL) presents as peripheral neuropathy with absent skin lesions and negative skin smears. Diagnosing PNL is an uphill task as most of these patients have nonspecific changes on nerve biopsy. In such circumstances, additional molecular diagnostic tools like polymerase chain reaction (PCR) has proven to be useful in diagnosing leprosy. Read More

    Early detection of neuropathy in leprosy: a comparison of five tests for field settings.
    Infect Dis Poverty 2017 Sep 1;6(1):115. Epub 2017 Sep 1.
    Department of Public Health, Erasmus MC, Rotterdam, The Netherlands.
    Background: Early detection and treatment of neuropathy in leprosy is important to prevent disabilities. A recent study showed that the Nerve Conduction Studies (NCS) and Warm Detection Thresholds (WDT) tests can detect leprosy neuropathy the earliest. These two tests are not practical under field conditions, however, because they require climate-controlled rooms and highly trained staff and are expensive. Read More

    A Macrophage Response to Mycobacterium leprae Phenolic Glycolipid Initiates Nerve Damage in Leprosy.
    Cell 2017 Aug;170(5):973-985.e10
    Department of Microbiology, University of Washington, Seattle, WA 98195, USA; Department of Immunology, University of Washington, Seattle, WA 98195, USA; Department of Medicine, University of Washington, Seattle, WA 98195, USA; MRC Laboratory of Molecular Biology, Molecular Immunity Unit, Department of Medicine, University of Cambridge, Cambridge CB2 OQH, UK. Electronic address:
    Mycobacterium leprae causes leprosy and is unique among mycobacterial diseases in producing peripheral neuropathy. This debilitating morbidity is attributed to axon demyelination resulting from direct interaction of the M. leprae-specific phenolic glycolipid 1 (PGL-1) with myelinating glia and their subsequent infection. Read More

    Extensive sonographic ulnar nerve enlargement above the medial epicondyle is a characteristic sign in Hansen's neuropathy.
    PLoS Negl Trop Dis 2017 Jul 28;11(7):e0005766. Epub 2017 Jul 28.
    Department of Neurology and Clinical Neurophysiology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
    Objective: Earlier studies have shown sonographic enlargement of the ulnar nerve in patients with Hansen's neuropathy. The present study was performed to determine whether sonography or electrophysiological studies can detect the specific site of ulnar nerve pathology in leprosy.

    Methods: Eighteen patients (thirty arms) with Hansen's disease and an ulnar neuropathy of whom 66% had borderline tuberculoid (BT), 27% lepromatous leprosy (LL) and 7% mid-borderline (BB) leprosy were included in the study. Read More

    Infectious diseases causing autonomic dysfunction.
    Clin Auton Res 2017 Jul 20. Epub 2017 Jul 20.
    Neurology Department, Raigmore Hospital, Inverness, UK.
    Objectives: To review infectious diseases that may cause autonomic dysfunction.

    Methods: Review of published papers indexed in medline/embase.

    Results: Autonomic dysfunction has been reported in retrovirus (human immunodeficiency virus (HIV), human T-lymphotropic virus), herpes viruses, flavivirus, enterovirus 71 and lyssavirus infections. Read More

    Multidrug therapy for leprosy: a game changer on the path to elimination.
    Lancet Infect Dis 2017 Sep 7;17(9):e293-e297. Epub 2017 Jul 7.
    Instituto Lauro de Souza Lima, Bauru, Brazil.
    Leprosy is present in more than 100 countries, where it remains a major cause of peripheral neuropathy and disability. Attempts to eliminate the disease have faced various obstacles, including characteristics of the causative bacillus Mycobacterium leprae: the long incubation period, limited knowledge about its mode of transmission, and its poor growth on culture media. Fortunately, the leprosy bacillus is sensitive to several antibiotics. Read More

    Anticeramide antibody and butyrylcholinesterase in peripheral neuropathies.
    J Clin Neurosci 2017 Aug 30;42:204-208. Epub 2017 May 30.
    Nireekshana-ACET/CODEWEL, Hyderabad, Telangana 500029, India. Electronic address:
    Ceramide is a glycosphingolipid, a component of nerve and non neuronal cell membrane and plays a role in maintaining the integrity of neuronal tissue. Butyrylcholinesterase (BChE) is a multifunctional enzyme, its involvement in neurodegenerative diseases has been well established. Anticeramide antibody (Ab-Cer) and enzyme BChE have been implicated in peripheral neuropathies. Read More

    Is Ross Syndrome an Autoimmune Entity? A Case Series of 11 Patients.
    Can J Neurol Sci 2017 May;44(3):318-321
    3Department of Neurology,Christian Medical College,Vellore,Tamil Nadu,India.
    Background: Ross syndrome is diagnosed by the presence of segmental anhidrosis, areflexia, and tonic pupils. Fewer than 60 cases have been described in literature so far. There have been reports of presence of antibodies in such patients, suggesting an autoimmune pathogenesis. Read More

    Ultrasound elastography assessment of the median nerve in leprosy patients.
    Muscle Nerve 2017 Sep 4;56(3):393-398. Epub 2017 Mar 4.
    Physics Department, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, University of São Paulo, Brazil.
    Introduction: We sought to compare median nerve elasticity between leprosy patients (LPs) and healthy volunteers (HVs) using ultrasound elastography (UE).

    Methods: Two radiologists independently measured the strain ratio of the median nerve/flexor digitorum superficialis muscle (MN/FDSM) of 18 LP and 18 HV using real-time freehand UE. Statistical analysis included intra-class correlation coefficients (ICC) and Mann-Whitney test. Read More

    A large-scale genome-wide association and meta-analysis identified four novel susceptibility loci for leprosy.
    Nat Commun 2016 Dec 15;7:13760. Epub 2016 Dec 15.
    Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong 250000, China.
    Leprosy, a chronic infectious disease, results from the uncultivable pathogen Mycobacterium leprae (M. leprae), and usually progresses to peripheral neuropathy and permanent progressive deformity if not treated. Previously published genetic studies have identified 18 gene/loci significantly associated with leprosy at the genome-wide significant level. Read More

    Leprosy in a patient infected with HIV.
    Pract Neurol 2017 Apr 9;17(2):135-139. Epub 2016 Dec 9.
    St George's University Hospitals, London, UK.
    A 60-year-old Nigerian man, who had lived in Europe for 30 years but had returned home frequently, presented with right frontalis muscle weakness and right ulnar nerve palsy, without skin lesions. Neurophysiology showed a generalised neuropathy with demyelinating features. Blood tests were positive for HIV, with a normal CD4 count. Read More

    Ultrasonography of Leprosy Neuropathy: A Longitudinal Prospective Study.
    PLoS Negl Trop Dis 2016 11 16;10(11):e0005111. Epub 2016 Nov 16.
    Radiology Division, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo Ribeirão Preto, São Paulo, Brazil.
    Background: Previous studies have shown that leprosy multi-drug therapy (MDT) does not stop the progression of nerve function impairment. There are no prospective studies investigating the evolution of nerve anatomic abnormalities after treatment. We examined leprosy patients aiming to investigate the evolution of nerve ultrasonography (US) abnormalities and the risk factors for poor outcomes after MDT. Read More

    Acro-osteolysis.
    Clin Rheumatol 2017 Jan 29;36(1):9-14. Epub 2016 Oct 29.
    Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, 41 110, Larissa, Greece.
    Acro-osteolysis is an osteolysis of the distal phalanges of the hands and feet and can affect the terminal tuft or the shaft of the distal phalanx (transverse or band acro-osteolysis). It is often associated with distal digital ischemia, digital calcinosis, or severe sensory neuropathy. Acro-osteolysis has been associated with a heterogeneous group of disorders, including occupational activities, infections, rheumatic disorders (systemic sclerosis, psoriatic arthritis), endocrinopathies, genetic disorders, and lysosomal storage disorders. Read More

    Evaluation of rheumatoid factor and anti-citrullinated peptide antibodies in relation to rheumatological manifestations in patients with leprosy from Southern Brazil.
    Int J Rheum Dis 2016 Oct 6;19(10):1024-1031. Epub 2015 Aug 6.
    Laboratório de Imunopatologia, Departamento de Patologia Médica, Clinical Hospital of Federal University of Parana, Curitiba, Brazil.
    Background: Leprosy patients may present several osteoarticular complaints, which require further evaluation of inflammatory diseases, such as rheumatoid arthritis (RA). Therefore, an adequate clinical assessment in addition to testing for rheumatoid factors (RF) and anticyclic citrullinated peptide antibodies (anti-CCP), can be useful in order to establish the correct diagnosis.

    Method: In this study, the relation of RF and anti-CCP with rheumatological manifestations was evaluated in 97 leprosy patients from Southern Brazil. Read More

    Leprosy with ulnar nerve abscess: ultrasound findings in a child.
    Skeletal Radiol 2017 Jan 27;46(1):137-140. Epub 2016 Oct 27.
    Radiology Division, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
    We report the ultrasound findings of a typical case of nerve abscess due to leprosy in an 11-year-old boy. The patient had previously undergone pediatric multibacillary leprosy multidrug therapy (MDT) in accordance with World Health Organization guidelines. He presented to our service with bilateral ulnar neuritis with no response to prednisone (1 mg/kg). Read More

    Evaluation of peripheral nerve lesions with high-resolution ultrasonography and color Doppler.
    Neurol India 2016 Sep-Oct;64(5):1002-9
    Department of Neurology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
    Purpose: Traditionally, peripheral nerve lesions are diagnosed on the basis of clinical history, physical examination, and electrophysiological studies, and the role of imaging studies has been limited. The purpose of the study was to assess the usefulness of sonography in diagnosing peripheral nerve lesions.

    Materials And Methods: Thirty adult patients with peripheral nerve lesion/s and 30 healthy adult volunteers were included in the study, and sonography of the relevant peripheral nerve/s was done. Read More

    [Pure neural leprosy. Diagnostic aspects of a clinical case].
    Rev Neurol 2016 Sep;63(6):257-61
    Complejo Hospitalario Universitario de Albacete, Albacete, Espana.
    Introduction: Leprosy is an infectious disease caused by the bacteria Mycobacterium leprae. It is particularly prone to affect the skin and the nerve trunks and, in fact, both are compromised in most infected patients. It is transmitted by exposure to those with the disease and sometimes by reactivation. Read More

    Subversion of Schwann Cell Glucose Metabolism by Mycobacterium leprae.
    J Biol Chem 2016 Oct 23;291(41):21375-21387. Epub 2016 Aug 23.
    From the Laboratório de Microbiologia Celular,
    Mycobacterium leprae, the intracellular etiological agent of leprosy, infects Schwann promoting irreversible physical disabilities and deformities. These cells are responsible for myelination and maintenance of axonal energy metabolism through export of metabolites, such as lactate and pyruvate. In the present work, we observed that infected Schwann cells increase glucose uptake with a concomitant increase in glucose-6-phosphate dehydrogenase (G6PDH) activity, the key enzyme of the oxidative pentose pathway. Read More

    Minocycline in leprosy patients with recent onset clinical nerve function impairment.
    Dermatol Ther 2017 Jan 23;30(1). Epub 2016 Aug 23.
    Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
    Nerve function impairment (NFI) in leprosy may occur and progress despite multidrug therapy alone or in combination with corticosteroids. We observed improvement in neuritis when minocycline was administered in patients with type 2 lepra reaction. This prompted us to investigate the role of minocycline in recent onset NFI, especially in corticosteroid unresponsive leprosy patients. Read More

    The role of primary infection of Schwann cells in the aetiology of infective inflammatory neuropathies.
    J Infect 2016 Nov 18;73(5):402-418. Epub 2016 Aug 18.
    Laboratoire d'Immunologie Clinique et Expérimentale de l'OI (LICE-OI), Centre recherche Immuno-clinique des agents pathogènes de l'OI (CRIC-AP OI) Pôle Biologie Santé, Hôpital Félix Guyon, CHU de la Réunion, Reunion. Electronic address:
    Numerous different pathogens are responsible for infective peripheral neuropathies and this is generally the result of the indirect effects of pathogen infection, namely anti pathogen antibodies cross reacting with epitopes on peripheral nerve, auto reactive T cells attacking myelin, circulating immune complexes and complement fixation. Primary infection of Schwann cells (SC) associated with peripheral nerve inflammation is rare requiring pathogens to cross the Blood Peripheral Nerve Barrier (BPNB) evade anti-pathogen innate immune pathways and invade the SC. Spirochetes Borrelia bourgdorferi and Trepomema pallidum are highly invasive, express surface lipo proteins, but despite this SC are rarely infected. Read More

    Renal amyloidosis in leprosy, an infrequent cause of nephrotic syndrome in Europe.
    BMJ Case Rep 2016 Aug 3;2016. Epub 2016 Aug 3.
    Department of Nephrologist, Hospital Universitario Principe de Asturias, Alcala de Henares, Spain.
    Leprosy is a chronic infectious disease caused by Mycobacterium leprae The main clinical manifestations involve the skin and the peripheral nervous system. Several types of nephropathy have been described in leprosy. One frequent form of renal involvement is amyloidosis, especially in patients with lepromatous leprosy. Read More

    Thermographic analysis and autonomic response in the hands of patients with leprosy.
    An Bras Dermatol 2016 May-Jun;91(3):274-83
    Universidade Federal de Uberlândia (UFU) - Uberlândia (MG), Brazil.
    Background: Low temperatures and slow blood flow may result from peripheral neuropathy caused by leprosy, and the simple detection of cold fingers could already be a preliminary classification for these patients.

    Objective: To investigate whether infrared thermography would be able to measure this change in temperature in the hands of people with leprosy.

    Method: The study assessed 17 leprosy patients who were under treatment at the National Reference Center for Sanitary Dermatology and Leprosy, Uberlândia/MG, and 15 people without leprosy for the control group. Read More

    Comprehensive electrophysiology in leprous neuropathy - Is there a clinico-electrophysiological dissociation?
    Clin Neurophysiol 2016 Aug 17;127(8):2747-55. Epub 2016 May 17.
    Department of Neurology, King George's Medical University, U.P., Lucknow 226003, India. Electronic address:
    Objective: The diagnosis of leprous neuropathy is mostly empirical and electrophysiological studies may not truly represent the clinical findings. This study comprehensively evaluates the neuroelectrophysiology and looks at clinico-electrophysiological dissociation.

    Methods: Conventional electrophysiological recording included evaluation of median, ulnar, radial, tibial, and common peroneal nerve; an extended protocol included great auricular, phrenic, and facial nerves, along with sympathetic skin response and blink reflex. Read More

    Regional Anaesthesia Management in a Patient with Leprosy: Rare Case with Rare Application.
    Turk J Anaesthesiol Reanim 2016 Feb 1;44(1):37-9. Epub 2016 Feb 1.
    Department of Anaesthesiology, İnönü University School of Medicine, Malatya, Turkey.
    Leprosy is a chronic infectious disease that is caused by Mycobacterium leprae and affects the skin and nerves. Patients with leprosy having related peripheral neuropathy and involvement of other organs may have cardiac, respiratory dysautonomia and autonomic dysfunctions. There are very few studies regarding anaesthetic management of patients suffering from leprosy. Read More

    Treatment of Peripheral Neuropathy in Leprosy: The Case for Nerve Decompression.
    Plast Reconstr Surg Glob Open 2016 Mar 17;4(3):e637. Epub 2016 Mar 17.
    Department of Plastic Surgery, Johns Hopkins University, Baltimore, MD; Department of Plastic Surgery, Luis Vernaza Hospital, Guayaquil, Ecuador; and Damien House Organization, Guayaquil, Ecuador.
    Plastic surgery has a tradition of caring for patients with facial deformity and hand deformity related to leprosy. The approach, however, to the progressive deformity and disability related to chronic nerve compression is underappreciated in the world today. A cohort of patients with leprous neuropathy from an indigenous area of leprosy in Ecuador was evaluated for the presence of chronic peripheral nerve compression, and 12 patients were chosen for simultaneous upper and lower extremity, unilateral, nerve decompression at multiple levels along the course of each nerve. Read More

    Correlation between clinical tests and electroneuromyography for the diagnosis of leprosy neuropathy.
    Lepr Rev 2016 Mar;87(1):60-70
    Background: In leprosy, sensory function of nerves is evaluated with monofilaments test and the motor function with voluntary muscle test, however electroneuromyography is considered as the gold-standard tool.

    Objectives: This study aimed: i) to evaluate the correlation between clinical tests and electroneuromyography for the diagnosis of leprosy neuropathy; and ii) to identify the prevalence of leprosy neuropathy and the most compromised peripheral nerves in leprosy.

    Methods: We analysed the data from a nested case-control study that identified 166 patients diagnosed with leprosy neuropathy confirmed by electromyography. Read More

    Corticosteroids for treating nerve damage in leprosy.
    Cochrane Database Syst Rev 2016 May 23(5):CD005491. Epub 2016 May 23.
    Department of Public Health, Erasmus Medical Center, PO Box 2040, Rotterdam, Netherlands, 3000 CA.
    Background: Leprosy causes nerve damage that can result in nerve function impairment and disability. Corticosteroids are commonly used for treating nerve damage, although their long-term effect is uncertain. This is an update of a review first published in 2007, and previously updated in 2009 and 2011. Read More

    Delayed Diagnosis, Leprosy Reactions, and Nerve Injury Among Individuals With Hansen's Disease Seen at a United States Clinic.
    Open Forum Infect Dis 2016 Mar 25;3(2):ofw063. Epub 2016 Mar 25.
    Division of Infectious Diseases, Department of Medicine , Emory University School of Medicine.
    Background.  Hansen's disease (HD), or leprosy, is uncommon in the United States. We sought to describe the characteristics of patients with HD in a US clinic, including an assessment of delays in diagnosis and HD reactions, which have both been associated with nerve damage. Read More

    Combination chemoprophylaxis and immunoprophylaxis in reducing the incidence of leprosy.
    Risk Manag Healthc Policy 2016 27;9:43-53. Epub 2016 Apr 27.
    Cebu Skin Clinic, Leonard Wood Memorial Center for Leprosy Research, Cebu City, the Philippines.
    Leprosy is a complex infectious disease caused by Mycobacterium leprae that is a leading cause of nontraumatic peripheral neuropathy. Current control strategies, with a goal of early diagnosis and treatment in the form of multidrug therapy, have maintained new case reports at ~225,000 per year. Diagnostic capabilities are limited and even with revisions to multidrug therapy regimen, treatment can still require up to a year of daily drug intake. Read More

    Nerve biopsy in Indian patients with mononeuropathy multiplex of undetermined etiology.
    Muscle Nerve 2017 Jan 13;55(1):23-27. Epub 2016 Oct 13.
    Department of Pathology, Dr Ram Manohar Lohia Institute of Medical Sciences, Gomtinagar, Lucknow, Uttar Pradesh, India.
    Introduction: A diagnosis of mononeuropathy multiplex (MM) requires detailed evaluation to determine etiology. We performed nerve biopsy on patients with MM in whom the etiology could not be established via other investigations.

    Methods: Sixty-eight patients with MM seen between January 2013 and June 2014 underwent detailed diagnostic evaluation. Read More

    Prevalence of leprous neuropathy determined by neurosensory testing in an endemic zone in Ecuador: Development of an algorithm to identify patients benefiting from early neurolysis.
    J Plast Reconstr Aesthet Surg 2016 Jul 7;69(7):966-71. Epub 2016 Apr 7.
    The Dellon Institutes for Peripheral Nerve Surgery, Towson, MD, USA. Electronic address:
    The success of a microneurosurgical intervention in leprous neuropathy (LN) depends on the diagnosis of chronic compression before irreversible paralysis and digital loss occurs. In order to determine the effectiveness of a different approach for early identification of LN, neurosensory testing with the Pressure-Specified Sensory Device™ (PSSD), a validated and sensitive test, was performed in an endemic zone for leprosy. A cross-sectional study was conducted to analyze a patient sample meeting the World Health Organization (WHO) criteria for Hansen's disease. Read More

    Field-Friendly Test for Monitoring Multiple Immune Response Markers during Onset and Treatment of Exacerbated Immunity in Leprosy.
    Clin Vaccine Immunol 2016 06 6;23(6):515-9. Epub 2016 Jun 6.
    Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
    Acute inflammatory reactions represent the major cause of irreversible neuropathy in leprosy. These tissue-destroying episodes have considerable overlap with acute immunological complications (flares) in several chronic (autoimmune) diseases that similarly warrant early detection. However, the lack of diagnostic tests impedes early diagnosis of these reactions. Read More

    Multiple Crush Concept Applied to Multiple Nerves in Leprous Neuropathy.
    Clin Podiatr Med Surg 2016 Apr 29;33(2):203-17. Epub 2016 Jan 29.
    Johns Hopkins University, Baltimore, MD, USA. Electronic address:
    There is a large reservoir of leprosy patients, no longer contagious, due to multidrug therapy, who are considered cured and are becoming increasingly disabled due to progressive chronic nerve entrapment in the upper and lower extremities. After a review of the history of understanding leprous neuropathy, an approach is outlined based on the approach taken to relieve pain and restore sensation that prevents ulcers and amputations in diabetics with neuropathy and superimposed nerve compressions. The results of the first application of this approach in an indigenous area for leprosy, Guayaquil, Ecuador, is discussed with implications for international care of this neglected patient population. Read More

    Tangier's disease: An uncommon cause of facial weakness and non-length dependent demyelinating neuropathy.
    Ann Indian Acad Neurol 2016 Jan-Mar;19(1):137-9
    Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
    Tangier disease is an autosomal recessive disorder characterized by an abnormal accumulation of cholesterol esters in various organs secondary to adenotriphosphate binding cassette transporter A-1 (ABCA-1) transporter deficiency and disrupted reverse cholesterol transport. It causes neuropathy in half of the affected individuals. We present the clinical, electrophysiological, and histopathological findings in a middle aged gentleman of Tangier disease who was initially misdiagnosed leprosy and treated with antileprosy drugs. Read More

    Painless Ulcers and Fissures of Toes: Hereditary Sensory Neuropathy, Not Leprosy.
    Indian J Dermatol 2016 Jan-Feb;61(1):121
    Department of Dermatology, SVS Medical College, Mahbubnagar, Telangana, India.
    Hereditary sensory neuropathies (HSN) are rare genetically determined neuropathies. They often manifest as painless injuries in children. We present HSN in a 5-year-old boy who presented with recurrent fissuring and ulceration involving both great toes. Read More

    Exploratory urinary metabolomics of type 1 leprosy reactions.
    Int J Infect Dis 2016 Apr 26;45:46-52. Epub 2016 Feb 26.
    Department of Infectious Diseases, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, Netherlands. Electronic address:
    Background: Leprosy is an infectious disease caused by Mycobacterium leprae that affects the skin and nerves. Although curable with multidrug therapy, leprosy is complicated by acute inflammatory episodes called reactions, which are the major causes of irreversible neuropathy in leprosy that occur before, during, and even after treatment. Early diagnosis and prompt treatment of reactions reduces the risk of permanent disability. Read More

    Microsurgical Reconstruction of Plantar Ulcers of the Insensate Foot.
    J Reconstr Microsurg 2016 Jun 24;32(5):402-10. Epub 2016 Feb 24.
    Department of Plastic and Reconstructive Surgery, A.J. Institute of Medical Sciences and A.J. Hospital & Research Centre, Mangalore, Karnataka, India.
    Background Plantar, neuropathic, or trophic ulcers are often found in patients with decreased sensation in the foot. These ulcers can be complicated by infection, deformity, and increased patient morbidity. Excision results in wider defects and local tissues are often insufficient for reconstruction Methods Total 26 free flaps were used in 25 patients to reconstruct plantar ulcers between years 2007 and 2013. Read More

    Inflammatory Cytokines Are Involved in Focal Demyelination in Leprosy Neuritis.
    J Neuropathol Exp Neurol 2016 Mar 17;75(3):272-83. Epub 2016 Feb 17.
    From the Leprosy Laboratory, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil (PRA, MRJ, ACCdS, SGA, RV, RBdSP, RBP, ROP, ENS); and Pedro Ernesto University Hospital, Rio De Janeiro State University, Rio de Janeiro, Brazil (MRJ, PSM).
    Mycobacterium leprae (ML) infection causes nerve damage that often leads to permanent loss of cutaneous sensitivity and limb deformities, but understanding of the pathogenesis of leprous neuropathy that would lead to more effective treatments is incomplete. We studied reactional leprosy patients with (n = 9) and without (n = 8) acute neuritis. Nerve conduction studies over the course of the reactional episode showed the findings of demyelination in all patients with neuritis. Read More

    Atraumatic Main-En-Griffe due to Ulnar Nerve Leprosy.
    Pol J Radiol 2016 1;81:1-4. Epub 2016 Jan 1.
    Department of Radiology, Topiwala National Medical College & BYL Nair Charity Hospital, Mumbai Central, Mumbai, India.
    Background: Leprosy is the most common form of treatable peripheral neuropathy. However, in spite of effective chemotherapeutic agents, neuropathy and associated deformities are seldom ameliorated to a significant extent. This necessitates early diagnosis and treatment. Read More

    Imaging techniques in leprosy clinics.
    Clin Dermatol 2016 Jan-Feb;34(1):70-8. Epub 2015 Nov 11.
    CODEWEL Nireekshana AIDS Care Education and Training (ACET), Narayanaguda, Hyderabad 500029, India.
    Leprosy is the most common treatable peripheral nerve disorder worldwide, with periods of acute neuritis leading to functional impairment of limbs and stigmatizing deformities. The nerve involvement in leprosy reactions, if recognized early and promptly treated with steroids and nerve release surgery, can be reversible. Currently, the nerve assessment in leprosy relies mainly on clinical assessment and nerve conduction studies. Read More

    Assessing nerves in leprosy.
    Clin Dermatol 2016 Jan-Feb;34(1):51-8. Epub 2015 Nov 6.
    Full Professor Department of Neurosciences of the School of Medicine of Ribeirão Preto-USP, São Paulo, Brazil. Electronic address:
    Leprosy neuropathy is dependent on the patient's immune response and expresses itself as a focal or multifocal neuropathy with asymmetric involvement. Leprosy neuropathy evolves chronically but recurrently develops periods of exacerbation during type 1 or type 2 reactions, leading to acute neuropathy. Nerve enlargement leading to entrapment syndromes is also a common manifestation. Read More

    An uncommon cause of bifacial weakness and non-length-dependent demyelinating neuropathy.
    Ann Indian Acad Neurol 2015 Oct-Dec;18(4):445-8
    Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
    Tangier disease is a rare metabolic disorder that causes neuropathy in half of the affected individuals. We present the clinical, electrophysiological, and histopathological findings in a middle-aged gentleman of Tangier disease who was initially diagnosed as leprosy and treated with antileprosy drugs. The presence of a demyelinating electrophysiology in a patient with predominant upper limb involvement and facial diplegia should raise the suspicion of Tangier disease. Read More

    Ulnar nerve sonography in leprosy neuropathy.
    J Med Ultrason (2001) 2016 Jan 31;43(1):137-40. Epub 2015 Jul 31.
    Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, NO. 58 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China.
    A 23-year-old woman presented with a half-year history of right forearm sensory and motor dysfunction. Ultrasound imaging revealed definite thickening of the right ulnar nerve trunk and inner epineurium, along with heterogeneous hypoechogenicity and unclear nerve fiber bundle. Color Doppler exhibited a rich blood supply, which was clearly different from the normal ulnar nerve presentation with a scarce blood supply. Read More

    The epidemiology and risk factors of chronic polyneuropathy.
    Eur J Epidemiol 2016 Jan 23;31(1):5-20. Epub 2015 Dec 23.
    Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands.
    Polyneuropathy is a disabling condition of the peripheral nerves, characterized by symmetrical distal numbness and paresthesia, often accompanied with pain and weakness. Although the disease is often encountered in neurological clinics and is well known by physicians, incidence and prevalence rates are not well known. We searched EMBASE, Medline, Web-of-science, Cochrane, PubMed Publisher, and Google Scholar, for population-based studies investigating the prevalence of polyneuropathy and its risk factors. Read More

    Establishing the reliability and construct validity of the Igbo version of Screening Activity Limitation and Safety Awareness scale in persons with Hansen disease.
    Lepr Rev 2015 Sep;86(3):220-8
    Objective: Leprosy or Hansen's disease is an infectious disease affecting skin and peripheral nerves. The World Health Organization (WHO) Recent Report reveals Africa as having 20,599 new cases, America 36, 178, Eastern Asia 166,445, Western pacific 5,400; totally up to 232,875 new cases. Nigeria as at 2012 had 3,805 new cases. Read More

    Amitriptyline 2% cream vs. capsaicin 0.75% cream in the treatment of painful diabetic neuropathy (Double blind, randomized clinical trial of efficacy and safety).
    Iran J Pharm Res 2015 ;14(4):1263-8
    Department of Internal Medicine, School of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran.
    Because of less systemic side effects of topical medications in pain relief of the painful form of diabetic peripheral neuropathy, this study aimed to compare the effect of amitriptyline and capsaicin cream in relieving pain in this condition. In this randomized, double-blind and non -inferiority trial, 102 patients received amitriptyline 2% and capsaicin 0.75% creams 3 times a day for 12 weeks on the feet. Read More

    Asymmetric Nerve Enlargement: A Characteristic of Leprosy Neuropathy Demonstrated by Ultrasonography.
    PLoS Negl Trop Dis 2015 Dec 8;9(12):e0004276. Epub 2015 Dec 8.
    Dermatology Division, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
    Background: Neurological involvement occurs throughout the leprosy clinical spectrum and is responsible for the most feared consequences of the disease. Ultrasonography (US) provides objective measurements of nerve thickening and asymmetry. We examined leprosy patients before beginning multi-drug therapy aiming to describe differences in US measurements between classification groups and between patients with and without reactions. Read More

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