@article{MAKHILLRJMS2024181231755,
    title = {Utility of S‐100 Immunostaining in the Demonstration of Nerve Changes in Borderline Leprosy},
    journal = {Research Journal of Medical Sciences},
    volume = {18},
    number = {12},
    pages = {787-791},
    year = {2024},
    issn = {1815-9346},
    doi = {makrjms.2024.12.787.791},
    url = {https://makhillpublications.co/view-article.php?issn=1815-9346&doi=makrjms.2024.12.787.791},
    author = {Sushma,B.,R. and},
    keywords = {Hansen’s disease, borderline leprosy, S‐100 immunostaining, schwann cells, nerve involvement, histopathology, Borderline tuberculoid, borderline borderline},
    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.}
    }