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Id: 17556 Author: Gill, A. L; Bell, D. R; Gill, G. V; Wyatt, G. B; Beeching, N. J Title: Leprosy in Britain: 50 years experience in Liverpool ..- Source: s.l; s.n; Jun. 2005. 7 p. tab, graf. Abstract: BACKGROUND: Leprosy is a chronic infection that presents with varying dermal and neurological symptoms, and which can lead to extensive disability and morbidity, often with accompanying social stigma. AIM: To review the patients presenting to the Liverpool School of Tropical Medicine (LSTM) between 1946 and 2003, looking specifically at country of birth and of infection, details of clinical presentation, diagnosis, management and reactions. DESIGN: Retrospective record review. METHODS: We retrieved all available clinical records for patients seen between 1946 and 2003 (n = 50), consisting of letters, hospital and LSTM casenotes, and some radiographs and photographs. Any history of tuberculosis or diabetes was recorded. RESULTS: Most patients (64%) were born in the Indian subcontinent, and most were thought to have contracted the disease there (62%). Features at presentation included anaesthetic skin lesions in 19 (36%), hypopigmentation in 15 (30%), and peripheral nerve enlargement in 25 (50%). Diagnoses were made by a combination of clinical data and biopsy (60%), and slit skin smears were positive for acid-fast bacilli in 61% of multibacillary patients. Initial presentation was with a leprosy reaction in five cases (10%), and reactions were documented in 42% of all patients. Treatments were varied, progressing from traditional Eastern medicine to the WHO-approved multidrug therapy in use today, with prophylaxis for children and close contacts. DISCUSSION: Leprosy remains an important diagnosis to consider in patients with a history of work or travel in the tropics, and is a diagnosis with far-reaching medical, social and emotional consequences. (AU). Descriptors: Inglaterra/EP Índia/EH Hansenostáticos/TU Hanseníase/DI/DT/*EP Estudos Retrospectivos Dermatopatias Bacterianas/DI/EP/PA Limits: Adolescente Adulto Idoso Criança Feminino Humanos Masculino Meia-Idade Location: BR191.1; 09335/s

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Id: 17549 Author: Boggild, Andrea K; Correia, Jason D; Keystone, Jay S; Kain, Keven C Title: Leprosy in Toronto: an analysis of 184 imported cases ..- Source: s.l; s.n; Jan. 2004. 5 p. tab. Abstract: BACKGROUND: Leprosy is a rare but serious mycobacterial infection. Immigration from areas where the disease is endemic has resulted in the importation of leprosy into countries where it is not endemic and where physicians and health care workers have little or no experience in diagnosis and therapy. In this study we characterized leprosy patients seen in a tropical disease unit that manages most of the reported leprosy cases in Canada. METHODS: We reviewed the clinical records of all 184 leprosy patients who were referred to the Tropical Disease Unit at Toronto General Hospital between 1979 and 2002 and abstracted demographic and clinical information. RESULTS: Patients were more likely to be male (122 or 66.3%) and of Indian (44 or 23.9%), Filipino (49 or 26.6%) or Vietnamese (37 or 20.1%) origin. Patients experienced symptoms for a mean of 4.8 years before referral to the Tropical Disease Unit. Most had no family history of leprosy (152/172 or 88.4%). Most patients presented with either borderline tuberculoid (80 or 43.5%) or borderline lepromatous (37 or 20.1%) disease. On average, patients presented with 5.8 skin lesions. Upper- and lower-extremity nerve dysfunction was common at presentation, with up to one-third of patients demonstrating either sensory or motor loss. A significantly greater lag time to presentation was observed in patients who emigrated from low-prevalence regions (p < 0.001). INTERPRETATION: Leprosy is a chronic infectious disease that is associated with serious morbidity if left untreated. Leprosy is uncommon in developed countries, but it is important for physicians to have a high index of suspicion when a foreign-born patient presents with chronic dermatitis and peripheral nerve involvement. (AU). Descriptors: Análise de Variância Distribuição de Qui-Quadrado Migração Internacional Índia/EH Hanseníase/*EP Ontario/EP Filipinas/EH População Urbana Vietnã/EH Limits: HUMANO MASCULINO FEMININO ADULTO MEIA-IDADE Location: BR191.1; 09327/s

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