Artigo Acesso aberto Produção Nacional Revisado por pares

Evaluation of agreement between clinical and histopathological data for classifying leprosy

2012; Elsevier BV; Volume: 17; Issue: 3 Linguagem: Inglês

10.1016/j.ijid.2012.10.003

ISSN

1878-3511

Autores

Victor Santana Santos, Pedro Teles de Mendonça Neto, Oscar Felipe Falcão Raposo, Ricardo Fakhouri, Francisco Prado Reis, Vera Lúcia Corrêa Feitosa,

Tópico(s)

Oral Health Pathology and Treatment

Resumo

The diversity of clinical manifestations of leprosy has given rise to different classification systems. However, there are important differences in the sensitivity and specificity of these classifications. The objective of this study was to evaluate the agreement between clinical and histopathological data for classifying leprosy.A total of 1265 patient reports containing clinical and histopathological data relating to the diagnosis and classification of leprosy were included in this study. The diagnostic concordance between the clinical form (Madrid classification) and the histopathological type, as well as the initial and final classifications, was calculated by dividing the number of concordant cases by the total number of patients.The overall agreement between the World Health Organization operational classification and the results of direct smear examination of the lesion for acid-fast bacilli was 84.8% (1073/1265). The clinical-histopathological agreement was 58.1% (735/1265). The indeterminate and lepromatous forms were those that showed the highest percentages of agreement: 72.1% (186/258) and 71.0% (142/200), respectively.Although classifications based on clinical characteristics have an important role in the control of leprosy, they present flaws that can influence the adequacy of treatment. Therefore, a histopathological examination is important for appropriate treatment.

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