Significance of Lepromin test (DTH) in diagnosis of indeterminate Leprosy

Abstract

Early detection and treatment can be beneficial for the check and progress of the disease in the community so we planned to tackle the disease in very early stage. Indeterminate stage is the earliest stage so it is very easier to treat this disease at this stage. The study was carried out at the skin outpatients department (OPD) and immunology unit of Department of Pathology, K.G.’s Medical College, Lucknow from October 1998 to Dec. 2001. Early response was measured after 48 hours of intradermal injection only 28 of 75 (37.3%) indeterminate leprosy cases gave positive response in which 20 of 75 (26.7%) cases gave 1+ response, 5 of 75 (6.7%) cases gave 2+ response and only 1 of 75 (1.3%) indeterminate cases gave 4+ DTH response. In diseases control groups 19 of 20 (95%) TT, 17 of 20 (85%) BT, 18 of 20 (90%) BB and 5 of 20 (25%) BL cases gave positive DTH response but DTH response is negative in all cases of lepromatous leprosy. Late reaction (Mitsuda response) was measured after 3 weeks of intradermal injection only 23 of 75 (30%) indeterminate leprosy cases gave positive response. Eight of 20 (40%) TT, 6 of 20 (30%) BT, 3 of 20 (15%) BB and 1 of 20 (5%) BL, disease control group gave positive response. Mitsuda response is negative in LL case. Most interesting observation was the detection of DTH of lepromin in 28 of 75 indeterminate cases, suggesting the usefulness of delayed reaction (in duration diameter measured after 48 hrs) in early diagnosis of in determinate leprosy.