RESUMEN
A group of 52 patients deemed to be cured of Hansen's disease were examined in order to determine the appearance or aggravation of bone lesions after cure. A study was made of X-rays performed both at the moment these patients were considered to be cured and a minimum of 2 years later. During the elapsing interval, new lesions had appeared in 8 patients, and existing lesions had worsened in 12 patients. Factors associated with the progression of lesions were: impaired sensitivity, physical activity and appearance of plantar ulcers. The authors feel that leprosy patients, even when considered to be bacteriologically cured, should undergo regular checkups. Factors which might aggravate bone lesions should be borne in mind.
Asunto(s)
Enfermedades Óseas/diagnóstico por imagen , Enfermedades Óseas/microbiología , Lepra/complicaciones , Cuidados Posteriores , Progresión de la Enfermedad , Ejercicio Físico , Femenino , Úlcera del Pie/microbiología , Humanos , Lepra/tratamiento farmacológico , Masculino , Radiografía , Estudios Retrospectivos , Factores de Riesgo , Trastornos de la Sensación/microbiología , Resultado del TratamientoRESUMEN
OBJECTIVE: To determine the incidence of bone islands in leprosy patients. DESIGN: X-rays of feet and hands of patients with Hansen's disease (leprosy) were reviewed retrospectively. A second group of related age- and sex-matched patients who did not have Hansen's disease was used for control purposes. Controls had undergone hand and foot X-rays during diagnosis of other pathologies. The patients with Hansen's disease were compared with the control groups, and were also analyzed as subgroups with different types of leprosy. The results were subjected to statistical analysis. PATIENTS: Ninety patients with Hansen's disease were randomly selected for this study. Patients who had had ulcers on hands or feet were excluded from the study. RESULTS AND CONCLUSIONS: Bone islands were demonstrated in 20 patients with Hansen's disease; no bone islands were observed in the controls. This was statistically significant (P < 0.01). Bone islands were only seen in patients with lepromatous leprosy and borderline types but were not demonstrated in patients with tuberculoid leprosy. There was also a statistically significant relationship for a disease duration of 15 years or more. The cause of this raised incidence of enostosis in leprosy patients is not clear, but there may be a genetic predisposition in patients with leprosy, or it may be a side effect of leprosy, especially the lepromatous form.