ABSTRACT
BACKGROUND: Leprosy can be considered to be the most common peripheral neuropathy of infectious etiology and constitutes a public health problem. The standard routine examination for assessing sensory impairment in leprosy neuropathy basically evaluates hands, feet and eyes. However, evaluation of facial cutaneous sensation is not routinely performed. OBJECTIVES: The aim of this study was to evaluate facial cutaneous sensation in patients with different clinical forms of leprosy and compare the findings with those from healthy individuals. METHODOLOGY: 19 healthy controls and 71 leprosy patients who were being treated at a national reference center for leprosy in Brazil underwent facial sensation assessment using the Semmes-Weinstein monofilament test. This test was applied over the facial areas corresponding to the ophthalmic, maxillary and mandibular distal branches of the trigeminal nerve. RESULTS: The predominant clinical form in terms of changes to facial cutaneous sensation was lepromatous leprosy (LL), followed by the borderline-borderline (BB), and borderline-lepromatous (BL) forms, in comparison with healthy individuals. The distal branches most affected were the zygomatic (28.2%; 20/71), buccal (23.9%; 17/71) and nasal (22.5%; 16/71). There was asymmetrical sensory impairment of the face in 62.5% (20/32) of the cases. CONCLUSION: The face is just as impaired in leprosy as are the feet, hands and eyes, but facial impairment is underdiagnosed. Our evaluation on the different sensory branches and evidence of asymmetrical impairment of the face confirm the classically described pattern of leprosy neuropathy, i.e. consisting of asymmetrical and predominantly sensory peripheral neuropathy.
Subject(s)
Face/physiopathology , Leprosy/classification , Leprosy/physiopathology , Sensation Disorders/epidemiology , Adult , Brazil/epidemiology , Case-Control Studies , Cross-Sectional Studies , Female , Humans , Incidence , Male , Middle Aged , Prognosis , Sensation Disorders/pathology , Young AdultABSTRACT
A hanseníase é uma doença infectocontagiosa de evolução crônica caracterizada por sinais e sintomas dermato neurológicos. Os clusters consistem em aglomerados com maior risco de adoecimento. A região do Triângulo Mineiro pertence ao cluster 9 de hanseníase do Brasil, sendo o município de Patrocínio/MG considerado de alta endemia. Este estudo teve como objetivo determinar a taxa de detecção de casos e identificar características epidemiológicas da hanseníase no município de Patrocínio/MG. Tratou-se de um estudo epidemiológico observacional, descrito e retrospectivo no período de 2001 a 2014. Os dados foram coletados na Vigilância Epidemiológica de Patrocínio/MG e analisados por meio de medidas estatísticas descritivas, como frequências absolutas, percentuais, médias, correlação de Pearson e o indicador epidemiológico de Coeficiente de Prevalência do Ministério da Saúde para a taxa de detecção de casos. Observou-se uma correlação significativa a de 1% pelo teste t, ou seja, à medida que aumenta a taxa de detecção da hanseníase nacional aumenta também a taxa de detecção em Patrocínio/MG.Na análise temporal, 50% dos anos analisados apresentaram taxa alta de detecção de casos novos, seguido da taxa média com 35,7% e taxa muito alta com 24,3%.O estudo epidemiológico da hanseníase em Patrocínio/MG evidenciou predominância do sexo masculino(64,82%), da raça caucasiana (62,06%), da forma clínica dimorfa (32,4%), da idade entre 31 e 40 anos (23,4%)e da zona urbana (97,59%). A realização deste estudo mostrou, de forma sucinta, dados de distribuição e características da população com hanseníase em Patrocínio/MG e podem ser usados para investigações futuras e direcionamento de estratégias e ações em saúde.
Leprosy is a contagious infectious disease of chronic evolution characterized by dermatological and neurological signs and symptoms. Clusters consist in areas with increased risk of disease. The region named Triangulo Mineiro belongs to Cluster 9 of leprosy in Brazil with Patrocínio considered highly endemic.This study aimed to determine the case detection rate and identify epidemiological characteristics of leprosy in the city of Patrocínio, Minas Gerais State.This was an observational, descriptive, retrospective epidemiological study of cases from 2001 to 2014. Data were collected from the Epidemiological Surveillance records of the city and analyzed using descriptive statistics including absolute frequencies,percentages and means. The Pearson correlationand the epidemiological indicator of the prevalencecoefficient of the Ministry of Health were used for thecase detection rate. There was a significant correlationof 1% according to the t-test, i.e., as the national leprosy detection rate increases, the detection rate in Patrocínio also increases. By temporal analysis, 50% ofthe years analyzed showed high detection rates for newcases, followed by medium and very high detectionrates for 35.7% and 24.3% of the years, respectively.The epidemiological study of leprosy in Patrocinioshowed a predominance of males (64.82%), Caucasians(62.06%), the borderline clinical form (32.4%), and age between 31 and 40 years (23.4%) with most cases livingin urban areas (97.59%). This study succinctly shows a distribution of data and population characteristics of leprosy in the city that can be used for future research to plan control strategies and health measures.
