Role of S-100 Immunostaining in Demonstration of Nerve Changes and Quantification of Dendritic Cells in Leprosy
Background: A definitive diagnosis of leprosy is based on a demonstration of either acid-fast bacilli or nerve elements within the granulomas. On routine hematoxylin and eosin stains, the nerve fibers are not easily identifiable. In this study, S-100 immunostain is used to highlight the nerve el...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2014-03-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/4100/13-%206436_E(Ra)_F(P)_PF1(PAK)_PFA(AK)_PFA2(AK)_New_PF2(PN).pdf |
| Summary: | Background: A definitive diagnosis of leprosy is based on
a demonstration of either acid-fast bacilli or nerve elements
within the granulomas. On routine hematoxylin and eosin stains,
the nerve fibers are not easily identifiable. In this study, S-100
immunostain is used to highlight the nerve elements and to
demonstrate and compare the nerve changes in spectrum of
leprosy including reactions.
Aim: To demonstrate the nerve changes in spectrum of leprosy
using S-100 immunostaining so as to categorize them for the
purpose of early diagnosis and treatment. We also want to
demonstrate and quantify the dendritic cells in lepromatous
spectrum of leprosy using S-100 immunostain.
Materials and Methods: Twenty consecutive skin biopsy
specimens from patients with histopathological diagnosis
of leprosy in the year 2012 were studied. Of these 20 cases,
13 were Borderline Tuberculoid, 1 was of indeterminate
leprosy, 1 Borderline Lepromatous, 2 cases of Lepromatous
Lep-rosy, 1 case of Type 1 reac-tion and 2 cases of Type 2
reaction. Stains used were Hematoxylin and Eosin stain for the
histopathological diagnosis, Fites stain for Bacillary index and
S-100 immunoperoxidase staining for nerve changes. 5 cases of
granulomatous dermatosis of skin other than leprosy (5 cases of
lupus vulgaris) were included as controls.
Results: On Hematoxylin and Eosin staining, the nerve fibers
showed vertical orientation in relation to epidermis in Borderline
Tuberculoid leprosy. In addition, the nerve fibers showed rounded
contour in Tuberculoid leprosy. The entire spectrum of leprosy
showed evidence of nerve damage in S-100 immunostaining
which was categorized in 4 patterns 1. Absent, 2. Fragmented, 3.
Discontinuous and 4. Intact. The majority of Borderline Tuberculoid
leprosy cases showed absent pattern of nerve damage.
Dendritic cells were also positive for S-100 immunostaining with
granular positivity in Borderline Tuberculoid Leprosy cases and
membranous positivity in Lepromatous spectrum.
Conclusion: Nerve damage is seen across the entire spectrum
of leprosy and the early identification of this nerve damage
using S-100 immunostaining, helps to differentiate between
Lepromatous and Tuberculoid leprosy, especially in the borderline
and indeterminate forms. |
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| ISSN: | 2249-782X 0973-709X |