02028nas a2200217   4500000000100000008004100001653000800042653001200050653003400062100001500096700001300111700001500124700001000139700001500149245007500164856005700239300001200296490000700308050001900315520147600334       2012                            d10aPCR10aleprosy10aEarly Diagnosis and Treatment1 aNatrajan M1 aKatoch K1 aKatoch V M1 aDas R1 aSharma V D00aHistological diagnosis of early and suspicious lleprosy by in situ PCR  uhttp://ijl.org.in/jul-sep/2%20M%20Natrajan%20(2).pdf  a185-1940 v84  aNATARAJAN 20123 aLeprosy 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.