title: Contribution of nasal biopsy to leprosy diagnosis.
abstract: BACKGROUND
  The nasal mucosa plays the main role as the entry and the exit of leprosy bacilli and the nasal involvement may precede the skin lesions by several years. Nasal biopsy has been used in research but its clinical application has not been described. We evaluated the contribution of the nasal biopsy for the diagnosis of leprosy and its correlation to skin biopsy and skin smear in untreated patients.
  
  
  METHODS
  We evaluated changes in nasal biopsy in 227 leprosy patients. Patients were clinically classified and skin and nasal biopsies and skin smear were performed.
  
  
  RESULTS
  Nasal biopsy showed positivity in 100% of the lepromatous spectrum decreasing toward the tuberculoid (TT) pole. Patients with TT or indeterminate forms did not present any nasal alterations, showing that they are the true paucibacillary forms. Also, the nasal biopsies of two patients were the only exam to show positivity. The bacillary index of the nasal biopsy was strongly correlated to skin biopsy and slit-skin smear. Additionally, the agreement among the exams was good, revealing the reliability of the nasal biopsy in leprosy diagnosis.
  
  
  CONCLUSIONS
  The present study showed a rate of 48% of positivity in nasal biopsy of untreated patients, correlating well with skin biopsy and skin smear. Thus, the method in leprosy diagnosis and clinical form classification has shown great reliability.
authors.affiliation: Division of Otorhinolaryngology, National Reference Center for Sanitary Dermatology and Leprosy, Clinical Hospital, Faculty of Medicine, Federal University of Uberlândia, Minas Gerais, Brazil.
authors.forename: Marcell
authors.initials: M
authors.lastname: Melo Naves
authors.forename: Lucas
authors.initials: L
authors.lastname: Gomes Patrocinio
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Patrocinio
authors.forename: Flávia Marques
authors.initials: FM
authors.lastname: Naves Mota
authors.forename: Antônio
authors.initials: A
authors.lastname: Diniz de Souza
authors.forename: Raul
authors.initials: R
authors.lastname: Negrão Fleury
authors.forename: Isabela Maria
authors.initials: IM
authors.lastname: Bernardes Goulart
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002648:Child; D018450:Disease Progression; D042241:Early Diagnosis; D006801:Humans; D007918:Leprosy / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D008875:Middle Aged; D009166:Mycobacterium leprae; D009297:Nasal Mucosa / Q000382:microbiology / Q000473:pathology*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D012867:Skin / Q000382:microbiology / Q000473:pathology*