{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T12:53:43Z","timestamp":1740142423630,"version":"3.37.3"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T00:00:00Z","timestamp":1717632000000},"content-version":"vor","delay-in-days":36,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003The diagnosis of Hansen disease (HD) can be difficult when acid-fast bacilli are not detected in the patient's skin sample.<\/jats:p><jats:p>\n          Objective\u2003To demonstrate that detailed morphological analysis of nonspecific inflammatory and\/or noninflammatory alterations in dermal nerves as well as skin adnexa in leprosy-suspected biopsy samples could improve the efficacy of histopathological diagnosis.<\/jats:p><jats:p>\n          Methods\u2003Patients with one to five skin lesions were enrolled in the study and classified into three groups by skin histopathology findings: Hansen disease (HD, n\u2009=\u200913), other diseases (OD, n\u2009=\u200911), and inconclusive cases (INC, n\u2009=\u200911). We quantified dermal nerve damage via the nerve lesion index (NLI) and PGP9.5-immunoreactive axon quantitative index in dermal nerves (AQI). We also measured inflammatory involvement of adnexa in cutaneous samples as indirect evidence of HD.<\/jats:p><jats:p>\n          Results\u2003We observed a higher median endoneurial inflammatory infiltrate NLI (HD\u2009=\u20090.5; INC\u2009=\u20090; OD\u2009=\u20090; p\u2009&lt;\u20090.001) and more frequent inflammatory involvement of skin adnexa in samples of the HD group compared with those of the INC and OD groups (HD\u2009=\u20097; INC\u2009=\u20091; OD\u2009=\u20090). However, samples from the INC and OD groups also showed inflammatory and noninflammatory damage of dermal nerves, with 2 or more kinds of alterations in nerves in the same sample (respectively: INC\u2009=\u2009in 1 and 2 samples; OD\u2009=\u2009in 3 and 5 respectively). The quantification of PGP9.5-immunoreactive axons in dermal nerves revealed no difference between the groups.<\/jats:p><jats:p>\n          Conclusion\u2003A detailed morphological analysis of cutaneous nerves in lesions with a suspicion of HD enabled us to select patients with nonspecific inflammatory or non-inflammatory lesions in the dermal nerves in the INC and OD groups, so they may be clinically monitored aiming at a possible future diagnosis of the disease. These INC and OD patients cannot have the HD diagnosis definitely excluded, and HD may coexist with another disease as a comorbidity.<\/jats:p>","DOI":"10.1055\/s-0044-1787136","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T23:07:03Z","timestamp":1717715223000},"page":"001-010","source":"Crossref","is-referenced-by-count":0,"title":["Immunohistochemical and histopathological analyses of cutaneous innervation to improve the diagnostic efficacy in hansen disease skin lesion"],"prefix":"10.1055","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3049-8431","authenticated-orcid":false,"given":"Eduardo Alves Freire da","family":"Costa","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz, Laborat\u00f3rio de Hansen\u00edase, Rio de Janeiro RJ, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7974-793X","authenticated-orcid":false,"given":"Tha\u00eds Porto","family":"Amadeu","sequence":"additional","affiliation":[{"name":"Universidade do Estado de Rio de Janeiro, Laborat\u00f3rio de Imunopatologia, Rio de Janeiro RJ, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1504-1553","authenticated-orcid":false,"given":"Ximena","family":"Illarramendi","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz, Laborat\u00f3rio de Hansen\u00edase, Rio de Janeiro RJ, Brazil."},{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Centro de Desenvolvimento Tecnol\u00f3gico em Sa\u00fade, Rio de Janeiro RJ, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7518-4321","authenticated-orcid":false,"given":"Bernardo","family":"Pascarelli","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz, Laborat\u00f3rio de Hansen\u00edase, Rio de Janeiro RJ, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0550-9327","authenticated-orcid":false,"given":"Jos\u00e9 Augusto da Costa","family":"Nery","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz, Laborat\u00f3rio de Hansen\u00edase, Rio de Janeiro RJ, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8024-6075","authenticated-orcid":false,"given":"Anna Maria","family":"Sales","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz, Laborat\u00f3rio de Hansen\u00edase, Rio de Janeiro RJ, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1653-1896","authenticated-orcid":false,"given":"S\u00e9rgio Luiz Gomes","family":"Antunes","sequence":"additional","affiliation":[{"name":"Instituto Oswaldo Cruz, Laborat\u00f3rio de Hansen\u00edase, Rio de Janeiro RJ, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,6,6]]},"reference":[{"key":"ref1","first-page":"492","volume-title":"Neuropatia da hansen\u00edase","author":"E D Alves","year":"2014"},{"issue":"01","key":"ref2","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1128\/CMR.00079-13","article-title":"Leprosy in the 21st century","volume":"28","author":"C White","year":"2015","journal-title":"Clin Microbiol Rev"},{"issue":"01","key":"ref3","first-page":"29","article-title":"Progression of acral bone resorption in multibacillary leprosy","volume":"12","author":"X Illarramendi","journal-title":"Acta Leprol"},{"issue":"01","key":"ref4","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.clindermatol.2014.07.008","article-title":"Mechanisms of nerve injury in leprosy","volume":"33","author":"D M Scollard","year":"2015","journal-title":"Clin 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