Wade histoid Leprosy: histological and immunohistochemical analysis

Wade histoid Leprosy: histological and immunohistochemical analysis

Author Costa, Daniela Aidar Monteiro da Autor UNIFESP Google Scholar
Enokihara, Mílvia Maria Simões e Silva Autor UNIFESP Google Scholar
Nonogaki, Suely Google Scholar
Maeda, Solange Miki Autor UNIFESP Google Scholar
Porro, Adriana Maria Autor UNIFESP Google Scholar
Tomimori, Jane Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Adolfo Lutz Inst
Abstract Histoid leprosy is a rare multibacillary form that presents with disseminated papule-nodular cutaneous lesions. To study the inflammatory infiltrate of the histoid form and to compare it with other lepromatous forms, we performed histological and immunohistochemical analysis on skin biopsies. Fifteen patients were included for histopathological analysis (10 histoid and five lepromatous) via the haematoxylin-eosin and Ziehl-Neelsen-Faraco stains. Thus, immunohistochemical techniques using immunoperoxidase assay were performed for: anti-BCG, anti-M. leprae, anti-CD8, anti-CD3, anti-CD20, anti-S100, anti-CD1a, anti-CD68 and antivimentin. Spindle cells were present in all histoid patients. A pseudocapsule was observed in half of both studied forms. A comparison using the Ziehl-Neelsen-Faraco stain to evaluate anti-BCG and anti-M.leprae showed no major differences. The CD3+ cells were more pronounced in the histoid form than the lepromatous form. There was greater immunoreactivity toward CD8+ cells in the histoid form, as well as the CD20+ cell count. A similar count of S100+ cells in the epidermis of both leprosy forms was observed. There was a slight increase of dendritic cells in the histoid patients in the superficial and deep dermis. For CD1a marker, we observed expression in the epidermis and superficial dennis in both forms. A diffuse and intense infiltrate of CD68+ cells was also observed in the histoid and lepromatous forms. The high positivity for vimentin did not allow for a positive cell count. We concluded that the activation of both the cellular and humoral response is more pronounced in the histoid form because the T and B cells showed greater infiltration than those in the lepromatous form. The activation of dendritic and Langerhans cells is similar in both forms. The spindle cells likely belong to the macrophage population, thus maintaining phagocytic ability. The quantities of pseudocapsules and bacilli are similar and cannot serve as criteria for diagnosis.
Language English
Sponsor Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Brazilian Ministry of Science and Technology
Date 2013-09-01
Published in Leprosy Review. Colchester: Lepra, v. 84, n. 3, p. 176-185, 2013.
ISSN 0305-7518 (Sherpa/Romeo, impact factor)
Publisher Lepra
Extent 176-185
Origin http://www.lepra.org.uk/platforms/lepra/files/lr/Sept13/1839.pdf
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000328999900002
URI http://repositorio.unifesp.br/11600/44853

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