What is the role of lab studies in the diagnosis of leprosy?

Updated: Jun 05, 2020
  • Author: Darvin Scott Smith, MD, MSc, DTM&H; Chief Editor: Michael Stuart Bronze, MD  more...
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Laboratory studies include the following:

  • Skin biopsy, nasal smears, or both are used to assess for acid-fast bacilli using Fite stain. Biopsies should be full dermal thickness taken from an edge of the lesion that appears most active. [15]
  • Serologic assays can be used to detect phenolic glycolipid-1 (specific for M leprae) and lipoarabinomannan (commonly seen in mycobacteria). [15] However, serological tests show low sensitivity for paucibacillary leprosy.
  • Molecular probes detect 40-50% of cases missed on prior histologic evaluation. Since probes require a minimum amount of genetic material (ie, 104 DNA copies), they can fail to identify paucibacillary leprosy.

Although the necessity of point-of-care and rapid diagnostic tests is recognized, these types of tests have yet to be developed.

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