- Virendra N Sehgal MD FNASc FAMS FRAS (Lond)
Clinical leprosy, ever since its first publication in the year 1979, has continued to provide an academic access to the understanding of the unique scourge, in tropics including India. Leprosy thus is responsible for making adequate material available for research, despite Mycobacterium leprae, its incriminating organism failing to fulfill the Koch’s postulates, the major impediment being its denial to grow in vitro, thus staking the major breakthrough. Accordingly, the diagnosis of leprosy continues to haunt, and is based primarily on cardinal clinical undertone supplemented by the demonstration of acid-fast-bacilli on slit-skin-smear. Although the latter is a reliable tool, yet it provides only a circumstantial evidence, because it has been repeatedly demonstrated from the lesions of cardinal morphology. Nevertheless, one of the major lacunas is inability to recover the organism on artificial culture. Microscopic pathology seems to surmount this diagnostic dilemma, but it only supplements and not supplant. Hence, it is worthwhile to take cognizance of all the parameters to facilitate its diagnosis, and subsequent treatment in right prospective to curtail the transmission of the disease. The concise facets, therefore, have been imbibed in the text to facilitate clearcut understanding of the disease. This is an academic exercise, which should meet the requirements of all those interested in the disease.
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