title: Diagnostic challenges of single plaque-like lesion paucibacillary leprosy.
abstract: The diagnosis of single-lesion paucibacillary leprosy remains a challenge. Reviews by expert dermatopathologists and quantitative polymerase chain reaction (qPCR) results obtained from 66 single-plaque biopsy samples were compared. Histological findings were graded as high (HP), medium (MP) or low (LP) probability of leprosy or other dermatopathy (OD). Mycobacterium leprae-specific genes were detected using qPCR. The biopsies of 47 out of 57 clinically diagnosed patients who received multidrug therapy were classified as HP/MP, eight of which were qPCR negative. In the LP/OD (n = 19), two out of eight untreated patients showed positive qPCR results. In the absence of typical histopathological features, qPCR may be utilised to aid in final patient diagnosis, thus reducing overtreatment and delay in diagnosis.
authors.affiliation: Instituto Nacional de Infectologia Evandro Chagas, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, RJ, Brasil.
authors.forename: Raquel Rodrigues
authors.initials: RR
authors.lastname: Barbieri
authors.affiliation: Laboratório de Hanseníase, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, RJ, Brasil.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Sales
authors.affiliation: Laboratório de Hanseníase, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, RJ, Brasil.
authors.forename: Ximena
authors.initials: X
authors.lastname: Illarramendi
authors.affiliation: Laboratório de Hanseníase, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, RJ, Brasil.
authors.forename: Milton Ozório
authors.initials: MO
authors.lastname: Moraes
authors.affiliation: Laboratório de Hanseníase, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, RJ, Brasil.
authors.forename: José Augusto da Costa
authors.initials: JA
authors.lastname: Nery
authors.affiliation: Laboratório de Hanseníase, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, RJ, Brasil.
authors.forename: Suelen Justo Maria
authors.initials: SJ
authors.lastname: Moreira
authors.affiliation: Laboratório de Hanseníase, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, RJ, Brasil.
authors.forename: Euzenir Nunes
authors.initials: EN
authors.lastname: Sarno
authors.affiliation: Laboratório de Hanseníase, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, RJ, Brasil.
authors.forename: Alice de Miranda
authors.initials: Ade M
authors.lastname: Machado
authors.affiliation: Instituto Nacional de Infectologia Evandro Chagas, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, RJ, Brasil.
authors.forename: Fernando Augusto
authors.initials: FA
authors.lastname: Bozza
mesh_terms: D001706:Biopsy / Q000145:classification; D004269:DNA, Bacterial / Q000032:analysis*; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D056005:Leprosy, Paucibacillary / Q000145:classification / Q000175:diagnosis*; D008297:Male; D009166:Mycobacterium leprae / Q000235:genetics*; D016133:Polymerase Chain Reaction / Q000379:methods; D012867:Skin / Q000293:injuries / Q000473:pathology*; D062606:Tertiary Care Centers
chemical_list: D004269:DNA, Bacterial