Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Hansen’s disease (leprosy) primarily affects the skin and peripheral nerves. Diagnosing borderline forms‐Borderline Tuberculoid (BT) and Borderline Borderline (BB)‐is often challenging due to overlapping clinical and histopathological features, particularly in paucibacillary cases with minimal bacillary load. Early and accurate detection of nerve involvement is critical to prevent long‐term complications. S‐100 immunostaining, a marker for Schwann cells, may enhance visualization of nerve structures in skin biopsies. Aim of the study was to assess the utility and diagnostic accuracy of S‐100 immunostaining in detecting nerve involvement in borderline leprosy cases and to compare its sensitivity with routine Hematoxylin and Eosin (H and E) staining. This observational study included 30 biopsy‐proven borderline leprosy cases (18 BT and 12 BB) over a period of one year. Skin punch biopsies were processed and stained with H and E, Fite‐Faraco (for Bacillary Index) and S‐100 immunostaining. Nerve involvement was categorized into infiltrated, fragmented, intact, or absent patterns. Sensitivity of H and E and S‐100 staining was calculated for both subtypes. S‐100 staining showed infiltrated nerve patterns in 94% of BT and 91% of BB cases. Fragmented nerves were observed in 8% of BB cases and intact nerves in 5% of BT cases. S‐100 immunostaining had a sensitivity of 100% in detecting nerve involvement in both BT and BB cases, while H and E showed 100% sensitivity in BT and 83.3% in BB cases. Two BB cases with negative H&E results were positive on S‐100 staining. S‐100 immunostaining significantly improves detection of nerve involvement in borderline leprosy, especially in diagnostically challenging BB cases. It is a valuable adjunct to routine histopathology and should be considered in all suspected leprosy biopsies to enhance diagnostic accuracy and support early treatment.
How to cite this article:
Sushma Yalavarthi, B. Hymavati, R. Ratna and M. Suma Reddy. Utility of S‐100 Immunostaining in the Demonstration of Nerve Changes in Borderline Leprosy.
DOI: https://doi.org/10.36478/makrjms.2024.12.787.791
URL: https://www.makhillpublications.co/view-article/1815-9346/makrjms.2024.12.787.791