Análise comparativa entre o diagnóstico clínico da hanseníase e os exames histopatológicos realizados segundo os critérios da classificação de Madrid e a de Ridley-Jopling

René Garrido NEVES; Myriam Dumas HAHN; Luiz Marino BECHELLI; Enzo MELCHIOR JR; Paulo Mucio Guimarães PAGNANO; Nagib HADDAD

doi:10.47878/hi.1982.v7.35596

Authors

René Garrido NEVES Prof. Adjunto. Coordenador da Disciplina de Dermatologia da Universidade Federal Fluminense. Niterói - RJBrasil
Myriam Dumas HAHN Prof. Assistente. Depto. de Patologia. Universidade Federal Fluminense. Niterói - RJ-Brasil.
Luiz Marino BECHELLI Prof. Titular de Dermatologia da Fac. Med. de Ribeirão Preto - SP-Brasil.
Enzo MELCHIOR JR Médico da disciplina de Dermatologia da Fac. Med. de Ribeirão Preto - SP-Brasil.
Paulo Mucio Guimarães PAGNANO Prof. Associado da disciplina de Dermatologia, Fac. Med. Ribeirão Preto - SP-Brasil.
Nagib HADDAD Prof. Titular do Depto. Medicina Social, Fac. Med. Ribeirão Preto - SP-Brasil.

DOI:

https://doi.org/10.47878/hi.1982.v7.35596

Keywords:

Hanseniasis, Classification, Pathology, Clinical diagnosis

Abstract

A comparative study of the Ridley-Jopling's (RJ) and of the Congress of Madrid's (CM) pathological criteria was made in the different clinical types and groups of hanseniasis. A concordance between both criteria was found in the Indeterminate group and in the regressive phases of the Virchowian (V), Tuberculoid (T) and Reactional tuberculoid (RT) types. Clinical RT was confirmed by pathology in 81.2% of the cases according to CM, whereas 46.2% were considered "Borderline" according to RJ. Out of the 48 clinically V patients, 17 (35.4%) were “Borderline” (BL-2, BL-1 and BB), but practically all were also pathologically V according to CM. It is concluded that there is no practical convenience in the establishment of histopathological sub-groups
that do not perfectly agree with clinical criteria. The Authors stress the importance of the study of the plasmocytes in the V infiltrates, of the lymphocytes in all granulomas and of the differences in the involvement of the neural ends, specially between the T and V poles. The dyeing of lipids by the Sudan III is useful to perfectly characterize the V pole, recognize residual V structures, separate the sub-groups BT, BB and BL, help in the early diagnosis of V infiltrations and differentiate the edematous, diffuse, non-granular cytoplasmatic vacuolization of RT. — A.R.

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