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Lucio Phenomenon (LPh) is a reactional state usually observed in untreated or inadequately treated leprosy and is a life-threatening medical emergency. Several cases of LPh have been reported in Indonesia, which is an endemic country with highest burden of new case besides India and Brazil. Generally, histopathological findings in LPh reveal granulomatous and panniculitis reactions with vascular infiltration of acid fast bacilli. However, it is still debatable whether the main pathophysiology of necrosis is due to occlusive vasculopathy or immune complex-mediated process. In this study, we report clinical and histopathological descriptions of 3 patients with LPh. The first case was resulted with severe necrosis, mortality and massive bacilli infiltration with endothelial damage on histopathology examination. The second and third case presented less severe manifestation with multiple ulcers covered with hemorrhagic crust and mild necrosis. The histopathology examination showed minimal inflammation on the endothelial. This serial case report showed that histopathological examination might be useful as a prediction value on LPh since it can characterize the basic pathogenesis process. Lucio Phenomenon (LPh) is a reactionary state usually observed in untreated or inadequately treated leprosy and is a life-threatening medical emergency. [ABSTRACT FROM AUTHOR]

Background: One of the indicators of achieved leprosy control is lower new cases of leprosy with grade 2 disability (G2D), while zero new pediatric case with G2D is one of the targets of The Global Leprosy Strategy. This study aimed to describe the characteristics of leprosy in children with G2D from seven provincial hospitals in Indonesia, spanning a period of five years. Methods: This was a descriptive and retrospective study with cross-sectional design. Data were obtained from the medical records of leprosy-affected children in seven provincial hospitals in Indonesia between January 2014 and December 2019 using a total sampling method. Data obtained include characteristics of patients, clinical manifestations, and profile of leprosy in children with G2D. Results: From the 132 data of childhood leprosy retrieved, male (58.33%), age group of 13– 14 years (47.73%), and borderline tuberculoid leprosy (34.09%) comprised the majority of patients. Most of the patients had anesthetic macules as the initial manifestation. The results showed 20 (15.15%) children had G2D. Hands were the most common site affected (50.00%), manifested as claw hands, contractures, atrophy of thenar and hypothenar muscles, and pseudomutilation. Foot drop was seen in five (62.50%) children, and lagophthalmos was seen in one child with leprosy. Conclusion: This study shows that G2D is observed in 15.15% Indonesian children with leprosy at the time of diagnosis, which mostly occurs on the hands in the form of claw hands. Foot disabilities were also observed, most commonly as foot drop, while lagophthalmos was present with disabilities in the eyes. Disability due to leprosy in children really exists. The commitment of all health care services and related institutions is needed in order to reduce the incidence of disability due to leprosy in children. [ABSTRACT FROM AUTHOR]

Introduction: this research aimed to analyze nerve growth factor (NGF) contents as diagnostic tools for early disability in leprosy patients and the cutoff point value. Methods: research samples consisted of 79 leprosy patients with disability grade 0 or 1 who met the clinically approved inclusion criteria. The age of patients ranged from 14 to 50 years. For both sample groups, blood serum was collected to determine NGF concentration. NGF level was analyzed by enzyme-linked immunosorbent assay (ELISA) according to the manual guide of the kit insert from Cussabio®. Statistical analysis used SPSS 17 software for Windows. A comparison was performed with the Student's t-test and the NGF concentration cut-off point was determined using a receiver operating characteristic (ROC) curve. Results: the research result demonstrated that NGF concentration in multibacillary leprosy with disability grade 0 was higher than in grade 1. Leprosy with disability grade 0 had an NGF content reaching 100.46 pg/mL, while those with grade 1 had a lower concentration of NGF at 30.56 pg/mL. The higher disability grade indicated a lower NGF concentration in the blood serum. Based on the ROC analysis result, the NGF cut-off was shown to be 81.43 pg/mL. This result indicated that low NGF in nerve and skin lesions of leprosy patients contributes to early peripheral nerve malfunction due to Mycobacterium leprae infection. Conclusion: these results prove that NGF can be used as a marker of early disability in leprosy, with the cut-off value at 81.43 pg/mL. [ABSTRACT FROM AUTHOR]

Introduction: Leprosy is a chronic infectious disease caused by Mycobacterium leprae that causes damage to the peripheral nerve, particularly Schwann cells. Treatment is useful only to kill bacteria but not to recover peripheral nerve damage. However, early detection of peripheral nerve damage is necessary. We examine P-75 neurotrophin (P75NTR) as an indicator of peripheral nerve damage in leprosy with the Semmes–Weinstein monofilament (SWM) test as the comparison. Methods: This study uses a quantitative analytic observational study approach with cross-sectional design, conducted at Kediri Leprosy Hospital, Malang, East Java, Indonesia. All leprosy patients had a clinical examination and bacterial index to classify leprosy and then the SWM test to examine the presence of neuropathy in the palms and feet. P75NTR examination uses venous blood samples. An independent t-test was used to compare the SWM and P75NTR scores based on the type of leprosy, and then the Spearman correlation test was used to determine the correlation between SWM scores and P75NTR levels. Results: In this study, SWM scores on the soles of the foot and palms and the P75NTR levels were higher in the PB group compared with MB (p< 0.05). Also, a significant positive correlation was found between P75NTR and the SWM scores on the palms of the hand (r=0.864; p=0.000) and the soles of the foot (r=0.864; p=0.000). Conclusion: There is a strong positive correlation between P75NTR levels and SWM scores, so P75NTR levels are very likely to be a marker of neuropathy in leprosy, but further studies are still needed to examine the specific role of these biomarkers. [ABSTRACT FROM AUTHOR]