S-100是结核样型麻风的一种有效辅助诊断
S-100 as a useful auxiliary diagnostic aid in tuberculoid leprosy作者机构：C-367 Saraswati Vihar Pitampura Delhi 110034 IndiaDr.
出 版 物：《世界核心医学期刊文摘（皮肤病学分册）》 (Digest of the World Core Medical JOurnals:Dermatology)
年 卷 期：2006年第2卷第11期
页 面：16-16页
学科分类：1002[医学-临床医学] 100206[医学-皮肤病与性病学] 10[医学]
主 题：结核样型麻风 结核样麻风 麻风患者 辅助诊断 皮肤肉芽肿 神经断裂 鉴别诊断 神经浸润 皮神经 肉芽
摘 要：Background: The diagnosis of tuberculoid leprosy is often difficult on hematoxylin and eosin (H&E) due to the absence of demonstrable nerve destruction. This study evaluates the utility of S-100 staining in identifying nerve fragmentation and differentiation of tuberculoid leprosy from other cutaneous granulomatous diseases. Methods: Fifty cases of leprosy including 38 borderline tuberculoid (BT), two tuberculoid (TT), and 10 indeterminate leprosy (IL)were studied. Eleven controls of non-lepromatous cutaneous granulomatous lesions were included. S-100 was used for identifying the following dermal nerve patterns: infiltrated (A), fragmented (B), absent (C), and intact (D) nerves. Results: On H&E, only 18/38 (47.4%) BT cases and 1/2 (50%) TT cases revealed neural inflammation. On S-100 staining of BT cases, 28/38 (73.7%) showed pattern B followed by patterns C and A in 8/38 (21.1%) and 2/38 (5.3%) cases, respectively. Both the TT cases showed pattern B. Only intact nerves (D) were seen in all the control cases. S-100 identified nerve damage in 4/10 (40%) IL cases. The patterns A, B, and C had sensitivity, specificity, and positive and negative predictive values of 100%in diagnosing tuberculoid (BT +TT) leprosy. Conclusions: S-100 is superior to H&E in identifying nerve fragmentation (p 0.01). It also aids the differential diagnosis of tuberculoid leprosy.
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