Hansen's Neuritis Revisited - A Clinicopathological Study

Area of Science:

• Neurology
• Dermatology
• Pathology

Background:

• Leprosy can affect nerves exclusively or alongside skin manifestations, presenting diagnostic difficulties.
• Hansen's neuritis (HN) contributes significantly to patient morbidity.
• Understanding the clinicopathological spectrum of HN is crucial for effective management.

Purpose of the Study:

• To elucidate the clinicopathological characteristics of Hansen's neuritis.
• To analyze diagnostic challenges and outcomes associated with HN.
• To provide insights into the histological subtypes and bacillary presence in HN cases.

Main Methods:

• A retrospective review of histologically diagnosed HN cases from January 2010 to July 2017.
• Analysis of clinical presentations, treatment histories, and patient outcomes.
• Histopathological examination including Fite-Faraco staining for lepra bacilli.

Main Results:

• 18 HN cases represented 3.97% of nerve biopsies; pure neuritic leprosy was most common (61.1%).
• Mononeuritis multiplex was frequently observed in nerve conduction studies.
• Histological findings varied, with borderline tuberculoid leprosy being the most prevalent subtype; lepra bacilli were detected in 44.4% of cases.

Conclusions:

• Accurate diagnosis of HN requires a thorough clinical evaluation, including skin assessment and neurological examination.
• Histopathological examination and demonstration of lepra bacilli are essential for confirming HN.
• Early and accurate diagnosis facilitates appropriate treatment and management of leprosy-induced nerve damage.