02229nas a2200313   4500000000100000008004100001260001700042653001500059653001000074653001100084653001100095653001200106653000900118653001600127653003000143653001600173100001000189700001200199700001200211700001400223700001200237245007500249856006100324300001100385490000700396050001900403520147900422022001401901       2012                            d  c2012 Jul-Sep10aAdolescent10aAdult10aFemale10aHumans10aleprosy10aMale10aMiddle Aged10apolymerase chain reaction10aYoung Adult1 aDas R1 aSharma 1 aKatoch 1 aNatrajan 1 aKatoch 00aHistological diagnosis of early and suspicious leprosy by in situ PCR.  uhttp://www.ijl.org.in/jul-sep/2%20M%20Natrajan%20(2).pdf  a185-940 v84  aNATARAJAN 20123 a<p>Leprosy is a chronic mycobacterial disease whose diagnosis is primarily based on clinico-pathological examination and supported by slit skin smears for the presence of acid fast bacilli (AFB). However, definitive diagnosis of early leprosy and those suspected to have the disease but not histologically confirmed pose major public health problems. The present study reports the utility of the in situ Polymerase Chain Reaction amplification (PCR) directed at a 530bp fragment of DNA encoding the 36kd antigen of the causative Mycobacterium leprae for the diagnosis of such patients using skin biopsies of lesions. Twenty five adult patients (aged 15-50yrs) each from the clinical categories of Early and clinically Suspect leprosy were selected for the study after obtaining permission. They had solitary lesions, which were negative for AFB on slit skin smear examination. Routine histopathology confirmed the diagnosis of leprosy in 8/25 (32%) cases in the category of Early leprosy with AFB being seen in 2 biopsies, and in 5/25(20%) cases of Suspect leprosy with AFB being seen in a solitary case. The Direct in situ PCR procedure which was performed in the histologically unconfirmed cases improved the diagnosis with positive results observed in 12/17 (70.6%) cases of Early (p=0.001) and in 12/20 (60%) cases of Suspect Leprosy (p=0.005 indicating the usefulness of the Direct in situ PCR to establish the diagnosis of leprosy in histologically doubtful cases.</p>  a0254-9395