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Serial Mitsuda tests for identification of reactional tuberculoid and reactional borderline leprosy forms

L C Lastoria1, D V Opromolla, R N Fleury

  • 1Department of Dermatology and Radiotherapy, Botucatu Medical School, UNESP, Brazil.

International Journal of Leprosy and Other Mycobacterial Diseases : Official Organ of the International Leprosy Association
|September 5, 1998
PubMed
Summary

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The Mitsuda reaction effectively differentiates between reactional tuberculoid and borderline leprosy. Reactional tuberculoid leprosy patients show stronger Mitsuda reactions and fewer bacilli compared to borderline cases.

Area of Science:

  • Dermatology
  • Infectious Diseases
  • Immunology

Background:

  • Leprosy presents diverse clinical and immunological manifestations.
  • Differentiating leprosy subtypes is crucial for effective treatment and management.
  • The Mitsuda reaction is an established immunological test in leprosy.

Purpose of the Study:

  • To evaluate the diagnostic utility of the Mitsuda reaction in distinguishing between reactional tuberculoid and reactional borderline leprosy.
  • To correlate Mitsuda reaction results with clinical, histopathological, and bacilloscopic findings.

Main Methods:

  • The Mitsuda reaction was assessed in 37 leprosy patients (18 reactional tuberculoid, 19 reactional borderline).
  • Evaluations were performed at 30, 60, 90, and 120 days post-reaction.

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  • Results were compared with clinical presentation, histopathology, and bacilloscopy.

    • Main Results:

    • Reactional tuberculoid patients predominantly exhibited a +3 Mitsuda reaction.
    • Reactional borderline patients showed a weaker Mitsuda reaction (+).
    • Bacilli were rare or absent in 75% of reactional tuberculoid cases, versus present in 95% of reactional borderline cases.

    Conclusions:

    • The Mitsuda reaction is a valuable tool for differentiating reactional tuberculoid from reactional borderline leprosy.
    • Reactional tuberculoid leprosy patients demonstrate a superior capacity for bacillary clearance.
    • Immunological response, as indicated by the Mitsuda reaction, correlates with bacterial load in leprosy.