(LML) Infoleps Choice of new (e) publications on leprosy - 20150119

Leprosy Mailing List – January 26,  2015

Ref.:   (LML)   Infoleps Choice of new (e) publications on leprosy - 20150119

From:  Grace Warren, Sidney, Australia

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Dear Pieter,

 

 

Thank you for updating us.  I have appreciated being able to look through the lists of papers and reading some.  I was very interested in the one from India about the prevalence at present.  I have heard that there is a high incidence of patients, in some countries at least,  who do actually have the disease caused by M.leprae but do not fulfil the official  WHO description for diagnosis ie a  skin lesion that is anaesethetic!!    I can certainly agree with that as in East Asia I have seen many patients with well-developed leprosy but who have no definite skin patches and no definite anaesthesia.

 

Then of course there are the  pure primary neuritic leprosy which I first met in Burma but later saw in many countries in which there is no skin lesion  but definite large nerves and neural deficits in many cases.  I was asked to see a teenager with one of these hand problems and there was no doubt it was due to leprosy but the  visiting  WHO consultant who had seen him a week before said Oh No he has no skin lesion!!!! 

 

Has anyone done an evaluation of how many of these are present as I suspect that the total of them would certainly increase the world wide statistics, if the ones we are given are for those who do comply with the WHO definition in the  WHO  book on diagnosis. Interesting thoughts -  one wonders how many are missed by well-intentioned workers.

 

Best wishes to your readers as they try and reduce the deformities and problems of these patients.

 

Grace  Warren

 

Previously consultant in Leprosy and reconstructive surgery in Asia for the Leprosy Mission International   (1975-1995)

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(LML) BT Hansen's Disease and nerve abscesses - surgical intervention or MDT alone?

Leprosy Mailing List – January 26, 2015

Ref.:   (LML) BT Hansen's Disease and nerve abscesses - surgical intervention or MDT alone? 

From:  Robert Jerskey, Carlsbad, California, USA

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Dear Dr. Pieter,

 

 

I enjoyed reading Dr. Sunil D. Ghate’s fascinating case presentation and query early this month, and then most recently, his follow-up report which included the nerve ultrasonography [N.U.] (LML January 22, 2015).

 

 

I have also found the posted responses very informative, including of the risks of surgical intervention and possible permanent nerve damage, the importance of monitoring for early nerve function deficit, and the value of crafting a medical regimen in order to best prevent the patient going in to a “full reaction”.  

 

 

Speaking of Reaction, I am reminded of a retrospective study published over two decades ago re: facial patches, type 1 reaction, and facial nerve damage, by Hogewig, Kiran, and Suneetha.  [see below **]  Though this case does not fit the criteria at this time, I reference the study because of the new information that has come to the fore:  a small facial lesion just lateral to the right eye.  Whether the patient is determined to be with PB or MB leprosy, or in Reaction or not, [and as alluded to by Dr. Warren, there are risks for potential Reaction during the course of tx] the fact that there is a facial patch proximal to the eye, though small, and multiple nerve enlargement in the L UE (Left Upper Extrimity), I would aim to carefully monitor the facial and trigeminal nerve function as well.   

 

 

And, again, with multiple UE nerve involvement there may also be LE nerve enlargement, if only incipient.  Incidentally, judging by the N.U. findings, there might be some enlargement in the right radial cutaneous nerve, comparing its diameter vis a vis the median nerve value on the same limb?

 

 

Good to read that there is thus far no sensory or motor impairment.   However, I am wondering which tool[s] are being used to identify early sensory impairment.  I read that the patient is being followed with TST and VMT.   Would Dr. Ghate clarify what is “TST”?  Likely to be Tactile Sensory Test.  [or Temperature?]  The tactile test covers quite a repertoire; might be with a pen, cotton, monofilaments, paper clip, etc.  I want to re-visit what Dr. Palande emphasized in his recent posting re: this same patient:  “…using graded nylons. Unless graded nylons are used one would not know if there is early nerve function deficit.”   If these, otherwise known as monofilaments [MF], have not been used, is there access to them in the clinic/hospital. so as to establish a fresh baseline?  Any insidious sensory deficits that might have been missed thus far can very likely be identified and measured with the graded MF. 

 

 

In summary, besides my request for clarification of the sensory testing tool[s], it would be helpful to monitor for any “red flags” at other key structures at risk of morbidity as the focus continues, understandably, on the L UE: to also carefully monitor nerve function in the other extremities and the eyes as well.

 

Thank you, Dr. Ghate, I look forward to reading of any further developments; your patient is clearly under well-orchestrated care.  

Friendly greetings to all LML readers,

 

 

Robert Jerskey, LOTR, P.O.D. consultant, based in Carlsbad, California, USA

robjerskey@yahoo.com

 

** See comment in PubMed Commons belowLepr Rev. 1991 Jun;62(2):143-9.  The significance of facial patches and type I reaction for the development of facial nerve damage in leprosy. A retrospective study among 1226 paucibacillary leprosy patients.

Hogeweg M¹, Kiran KU, Suneetha S.

 

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(LML) BT Hansen's Disease and nerve abscesses - surgical intervention or MDT alone?

Leprosy Mailing List – January 26,  2015

Ref.:  (LML) BT Hansen's Disease and nerve abscesses - surgical intervention or MDT alone?

From:  Dinkar Palande, Pondicherry, India

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Dear Pieter,

 

Thanks to Dr. Ghate for his excellent report and the Ultrasound report (LML January 22, 2015). My comments and suggestions are :

 

I hope that the sensory assessment is being done with 4 graded nylon filaments. 

 

I expect that the abscess in the ulnar nerve is, as has been said in the UST report, in a branch of a cutaneous nerve. It may be resolving. If it increases in size then it will cause compression that can be detected by the various signs and symptoms. Then after a course of steroids decompression would be indicated. If a sinus occurs decompression is also indicated but not urgently.

 

At present just keep on monitoring.

 

In case of detecting any nerve function deficit start on prednisolon and if no improvement in 2 weeks suggest decompression.

 

 

Best wishes,

 

dinkar d palande

from dinkar d. palande

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(LML) BIKASH Nepal International Training 2015

Leprosy Mailing List – January 20,  2015

Ref.:    (LML) BIKASH Nepal International Training 2015

From:  Dr. Gopal Gurung, Pokhara, Nepal

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Dear Dr. Pieter,

May I please request you to circulate our training announcement through the LML once again?

 

	BIKASH Nepal International Training 2015
	Training Title	Duration	Target Audience/Participant	Training Dates	Fee USD
	Rehabilitation and Prevention of Disability (RPOD)	2 weeks	Managers, supervisors and coordinators of GO and NGOs working for rehabilitation of persons with disability and affected by leprosy	09-20 March	1250
	Basic Training in Dermatology	1 week	Medical Doctors and Sr. Leprosy Staff	19-24 April	400
	Basic Training in Leprosy	1 week	Medical Doctors and Sr. Leprosy Staff	26 April-01 May	400
	Disability Research, Advocacy Skills Training in Communication (DRASTIC)	1 week	Counselor, Trainers, Activists of Disability Rights	04- 09 May	750

 

For detail training information, please contact:

E-mail: Gopal Gurung ggurung@bikashnepal.org.np

Phone: 00977 61 430562 and 00977 61 431052

 

Thank you,

Dr. Gopal Gurung

Pokhara, Nepal

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(LML) BT Hansen's Disease and nerve abscesses - surgical intervention or MDT alone?

Leprosy Mailing List – January 22,  2015

Ref.:     (LML) BT Hansen's Disease and nerve abscesses - surgical intervention or MDT alone?

From:  Sunil D. Ghate, Mumbai, India

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Dear Dr Pieter, 

 

Thanks for posting this case for discussion on LML (LML January 9, 2015). Some additional information: the patient has a skin lesion of size 4 cm on dorsum of the left hand ( this was also biopsied, confirmed as BTH). He also has another small patch of size 1 cm just lateral to the right eye. The thickened nerves are only in left upper extremity.

 

I am following up this patient with TST & VMT. There is no sensory or motor impairment as of today.

 

The patient has already completed 1 month of MDT. He is being followed up & is not on steroids. If he develops NFI, I shall put him on prednisolone.

 

No surgical intervention is planned at this moment in time.

 

The clinical tests as suggested by Dr Palande (LML January 11,2015) are all negative.

 

Here is the ultrasonography report of the patient (see attached file).

 

I  appreciate suggestions/comments to manage this patient and keep you posted on the progress of this patient.

 

Regards,

 

DR SUNIL D GHATE
MD,DNB,DDV,MNAMS
CONSULTANT DERMATOLOGIST

Mumbai, India

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(LML) Infoleps Choice of new (e) publications on leprosy - 20150119

Leprosy Mailing List – January 22, 2015

Ref.:  (LML)   Infoleps Choice of new (e) publications on leprosy - 20150119

From:  Jiske Erlings, INFOLEP, NLR, Amsterdam, the Netherlands

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Dear Pieter,

Greetings from Infolep!

Below you will find a selection of recent publications on leprosy. Feel free to contact me to receive the full text versions if a link to the full text is not included.

You might have heard that we are working on expanding the Infolep portal with publications on cross-cutting issues in Neglected Tropical Diseases. An overview of this rapidly growing collection can be found here: http://www.leprosy-information.org/category/collection/infontds-cross-cutting-issues

 

With kind regards,

 

Jiske Erlings

INFOLEP Information specialist

Follow Infolep on Facebook or Twitter

 

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New Journal Articles

 

Assiri A, Yezli S, Tayeb T, Almasri M, Bamgboye AE, Memish ZA. Eradicating leprosy in Saudi Arabia: Outcome of a ten-year surveillance (2003-2012). Travel Med Infect Dis. 2014 Oct 16;12(6PB):771-777. Abstract: http://www.leprosy-information.org/resource/eradicating-leprosy-saudi-arabia-outcome-ten-year-surveillance-2003-2012

Balamayooran G, Pena M, Sharma R, Truman RW. The armadillo as an animal model and reservoir host for Mycobacterium leprae. Clin Dermatol. 2015 Jan-Feb;33(1):108-15. Abstract: http://www.leprosy-information.org/resource/armadillo-animal-model-and-reservoir-host-mycobacterium-leprae

Carvalho KA. [Discussions regarding the reconstruction of the significance of leprosy in the post-sulfone period, Minas Gerais, in the 1950s.]. Hist Cienc Saude Manguinhos. 2014 Dec 19;0:0. Free full text: http://www.leprosy-information.org/resource/discussions-regarding-reconstruction-significance-leprosy-post-sulfone-period-minas-gerais

Chandler DJ, Hansen KS, Mahato B, Darlong J, John A, Lockwood DN.
Household Costs of Leprosy Reactions (ENL) in Rural India. PLoS Negl Trop Dis. 2015 Jan15;9(1):e0003431. Free full text: http://www.leprosy-information.org/resource/household-costs-leprosy-reactions-enl-rural-india

Cordeiro TL, Cipriani Frade MA. Leprosy: Education as first priority. J Neurosci Rural Pract. 2014 Nov;5(Suppl 1):S3-4. Free full text: http://www.leprosy-information.org/resource/leprosy-education-first-priority

de Almeida-Neto FB, Assis Costa VM, Oliveira-Filho AF, de Souza Franco E, Tavares Julião de Lima EV, Barros de Lorena VM, Oliveira de Souza VM, de Sousa Maia MB. T(H) 17 cells, interleukin-17 and interferon- γ in patients and households contacts of leprosy with multibacillary and paucibacillary forms before and after the start of chemotherapy treatment. J Eur Acad Dermatol Venereol. 2014 Nov 27. bstract: http://www.leprosy-information.org/resource/th17-cells-interleukin-17-and-interferon-patients-and-households-contacts-leprosy

de Souza Aarão TL, Esteves NR, Esteves N, de Miranda Soares LP, da Silva Pinto D, Fuzii HT, Quaresma JA. Relationship between growth factors and its implication in the pathogenesis of leprosy. Microb Pathog. 2014 Dec;77:66-72. Abstract: http://www.leprosy-information.org/resource/relationship-between-growth-factors-and-its-implication-pathogenesis-leprosy

Escamilla-Tilch M, Estrada-García I, Granados J, Arenas-Guzmán R, Ramos-Payan R, Pérez-Suárez TG, Salazar MI, Pérez-Lucas RL, Estrada-Parra S, Torres-Carrillo NM. Lack of Association of the Polymorphisms IL-17A (-197G/A) and IL-17F (+7488A/G) with Multibacillary Leprosy in Mexican Patients. Int J Genomics. 2014;2014:920491. Free full text: http://www.leprosy-information.org/resource/lack-association-polymorphisms-il-17a-197ga-and-il-17f-7488ag-multibacillary-leprosy

Heeren M-J J, Ky L, Van Brakel WH. Perceived Needs Related to Social Participation of People with Leprosy-related Disabilities and other People with Disabilities in Cambodia: A Qualitative Study. DCID. 2014;25(3):22-44.Free full text: http://www.leprosy-information.org/resource/perceived-needs-related-social-participation-people-leprosy-related-disabilities-and-other

Juarez-Ortega M, Hernandez VG, Arce-Paredes P, Villanueva EB, Aguilar-Santelises M, Rojas-Espinosa O. Induction and treatment of anergy in murine leprosy. Int J Exp Pathol. 2014 Dec 21. Abstract: http://www.leprosy-information.org/resource/induction-and-treatment-anergy-murine-leprosy

Kim EJ, Cho KH, Yoon HS, Cho S, Park HS. An unsuspected case of relapsed multibacillary leprosy. Ann Dermatol. 2014 Dec;26(6):758-9. Free full text: http://www.leprosy-information.org/resource/unsuspected-case-relapsed-multibacillary-leprosy

Misra DP, Parida JR, Chowdhury AC, Pani KC, Kumari N, Krishnani N, Agarwal V. Lepra reaction with lucio phenomenon mimicking cutaneous vasculitis. Case ReportsImmunol. 2014;2014:641989. ee full text: http://www.leprosy-information.org/resource/lepra-reaction-lucio-phenomenon-mimicking-cutaneous-vasculitis

Quaresma JA, Aarão TL, Sousa JR, Botelho BS, Barros LF, Araujo RS, Rodrigues JL, Prudente DL, Pinto DS, Carneiro FR, Fuzii HT. Th17 cytokines expression in leprosy skin lesions. Br J Dermatol. 2014 Dec 15. Abstract: http://www.leprosy-information.org/resource/th17-cytokines-expression-leprosy-skin-lesions

Rath D, Bhargava S, Kundu BK. Leprosy mimicking common rheumatologic entities: a trial for the clinician in the era of biologics. Case Rep Rheumatol. 2014;2014:429698. Free full text: http://www.leprosy-information.org/resource/leprosy-mimicking-common-rheumatologic-entities-trial-clinician-era-biologics

Sardana K, Goel K. Nasal septal ulceration. Clin Dermatol. 2014 Nov-Dec;32(6):817-26. Read abstract: http://www.leprosy-information.org/resource/nasal-septal-ulceration

Sauer ME, Salomão H, Ramos GB, D Espindula HR, Rodrigues RS, Macedo WC, Sindeaux RH, Mira MT. Genetics of leprosy: Expected and unexpected developments and perspectives. Clin Dermatol. 2015 Jan-Feb;33(1):99-107. Abstract: http://www.leprosy-information.org/resource/genetics-leprosy-expected-and-unexpected-developments-and-perspectives

Savage JA, Levis WR. The utility of QuantiFERON-TB Gold assay in patients with leprosy: A possible measure of anergy. J Am Acad Dermatol. 2014 Nov;71(5):996-7.
Abstract: http://www.leprosy-information.org/resource/utility-quantiferon-tb-gold-assay-patients-leprosy-possible-measure-anergy

Scollard DM, Martelli CM, Stefani MM, Marojoa MD, Villahermosa L, Pardillo F, Tamang KB. Risk Factors for Leprosy Reactions in Three Endemic Countries. Am J Trop Med Hyg. 2014 Dec 1. pii: 13-0221. Abstract: http://www.leprosy-information.org/resource/risk-factors-leprosy-reactions-three-endemic-countries

Singh I, Yadav AR, Mohanty KK, Katoch K, Sharma P, Mishra B, Bisht D, Gupta UD, Sengupta U. Molecular mimicry between Mycobacterium leprae proteins (50S ribosomal protein L2 and Lysyl-tRNA synthetase) and myelin basic protein: A possible mechanism of nerve damage in leprosy. Microbes Infect. 2015 Jan 8. pii: S1286-4579(14)00337-2. Abstract: http://www.leprosy-information.org/resource/molecular-mimicry-between-mycobacterium-leprae-proteins-50s-ribosomal-protein-l2-and-lysyl

Turner D, McGuiness S, Leder K. Leprosy: diagnosis and management in a developed setting. Intern Med J. 2015 Jan;45(1):109-12. Abstract: http://www.leprosy-information.org/resource/leprosy-diagnosis-and-management-developed-setting

Vashisht D, Das AL, Vaishampayan SS, Vashisht S, Joshi R. Nerve conduction studies in early tuberculoid leprosy. Indian Dermatol Online J. 2014 Dec;5(Suppl 2):S71-5. Free full text: http://www.leprosy-information.org/resource/nerve-conduction-studies-early-tuberculoid-leprosy

Wheat WH, Casali AL, Thomas V, Spencer JS, Lahiri R, Williams DL, McDonnell GE, Gonzalez-Juarrero M, Brennan PJ, Jackson M. Long-term Survival and Virulence of Mycobacterium leprae in Amoebal Cysts. PLoS Negl Trop Dis. 2014 Dec 18;8(12):e3405. Free full text: http://www.leprosy-information.org/resource/long-term-survival-and-virulence-mycobacterium-leprae-amoebal-cysts

Yadav N, Kar S, Madke B, Dashatwar D, Singh N, Prasad K, Kesari V.
Leprosy elimination: A myth busted. J Neurosci Rural Pract. 2014 Nov;5(Suppl 1):S28-32.Free full text: http://www.leprosy-information.org/resource/leprosy-elimination-myth-busted

  

Journals  & Newsletters

 

Clinics in Dermatology, Jan, Feb 2015, Special issue on leprosy: http://www.cidjournal.com/

Disability, CBR & Inclusive Development: http://dcidj.org/

Leprosy Review: http://www.lepra.org.uk/Pages/FAQs/Category/volume-85

 

WHO Goodwill Ambassador's Newsletter for the elimination of leprosy: http://www.leprosy-information.org/resource/who-goodwill-ambassador-s-newsletter-elimination-leprosy

 

Infolep Leprosy Information Services

Postbus / P.O. Box 95005 1090 HA Amsterdam The Netherlands Tel: +31 20 5950530 Mob: - Email: J.Erlings@Leprastichting.NL Web: www.leprosy-information.org

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LML - S Deepak, B Naafs, S Noto and P Schreuder

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(LML) The Enablement's course calendar for 2015

Leprosy Mailing List – January 18,  2015

Ref.:    (LML) The Enablement's course calendar for 2015

From:  Evert Veldman, the Netherlands

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Dear colleague,

We hope the year 2015 will bring you lots of success and inspiration. A specialized course in the field of Community Based Rehabilitation, Disability and Development may serve that goal. Find in the attached file the Enablement's course calendar for 2015. Please don't hesitate to contact us should you have any questions.

Enablement is a training, research and development institute that is specialized in Community Based Rehabilitation (CBR) and inclusive development. Enablement understands CBR as a strategy that aims to improve the quality of life of persons with disabilities. It involves working closely with persons with disabilities, their families and stakeholders at all levels to include persons with disabilities in every domain of community life.

We believe that CBR as a strategy for inclusion can only be effectively developed and implemented when CBR workers are trained to be agents of change, networkers and creative problem solvers. We enhance reflective reasoning as the core learning principle in building capacity. We try to contribute to innovation of educational approaches, tools and materials for anyone involved in CBR from grassroots to top management level. We are not satisfied with our interventions until persons with disabilities have an improved quality of their day-to-day lives.    

Our associate members form an international team of committed disability and rehabilitation professionals from various academic fields. This multi-disciplinary team consists of well-experienced researchers, evaluators, specialists in organizational and institutional development, lobbyists and trainers. We work together with an extensive international network of universities and international governmental and non-governmental organizations. 

Enablement | A van Leeuwenhoekweg 38 unit A16 | 2408 AN Alphen aan den Rijn | The Netherlands

With kind regards,

Evert Veldman

www.enablement.nl

www.cbrtraining.com

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