1.Factors affecting colorectal cancer and precancerous lesions among cured leprosy patients
Xiaohai ZHANG ; Huijuan SHI ; Hongtao ZHANG ; Hu ZHONG ; Min YAO ; Youji TAN
Journal of Preventive Medicine 2022;34(12):1257-1261
Objective:
To investigate the influencing factors of colorectal cancer and precancerous lesions among cured leprosy patients, so as to provide insights into prevention of colorectal cancer among cured leprosy patients.
Methods:
All cured leprosy patients were recruited from each leprosy village (hospital) in Zhejiang Province from 2019 to 2020. Participants' demographic features, family and medical history of intestinal polyps, smoking, alcohol consumption, dietary behaviors and defecation during the recent three years were collected using questionnaire surveys. Colorectal cancer and precancerous lesions were diagnosed using rectal examination, electronic colonoscopy and histopathological examinations, and factors affecting the development of colorectal cancer and precancerous lesions were identified with a multivariable logistic regression model among cured leprosy patients.
Results:
Totally 100 cured leprosy cases were enrolled, including 72 men and 28 women, and with a mean age of (67.23±3.42) years. There were 13 cases with grade 0 leprosy disability, 16 cases with grade 1 leprosy disability and 71 cases with grade 2 leprosy disability. The detection of colorectal cancer and precancerous lesions was 5.00% and 26.00%, respectively. Multivariable logistic regression analysis showed that age of 65 years and older (OR=7.128, 95%CI: 5.019-10.123), disability (OR=4.591, 95%CI: 2.942-7.163), a medical history of intestinal polyps (OR=4.031, 95%CI: 3.052-5.325), eating moldy food frequently (OR=4.433, 95%CI: 2.920-6.729), seldom eating vegetables (OR=4.411, 95%CI: 3.204-6.071), bloody stools (OR=4.341, 95%CI: 2.771-6.799), mucous stools (OR=4.577, 95%CI: 2.771-7.559) and presence of depression (OR=3.935, 95%CI: 3.026-5.117) were statistically associated with the development of colorectal cancer and precancerous lesions among cured leprosy patients.
Conclusion
Advanced age, disability, history of intestinal polyps, frequent intake of moldy food, infrequent consumption of vegetables, bloody stools, mucous stools, and depression may increase the risk of colorectal cancer and precancerous lesions among cured leprosy patients.
2.A case report of leprosy reaction combined with bullous pemphigoid after treatment of paucibacillary leprosy
Youji TAN ; Mengmeng WANG ; Guoli SHEN ; Yanmin WANG
Shanghai Journal of Preventive Medicine 2022;34(4):376-377
ObjectiveTo investigate the clinical characteristics of leprosy-related neuritis with bullous pemphigoid after treatment of paucibacillary leprosy. MethodsThe treatment of leprosy reaction combined with bullous pemphigoid of a cured case of leprosy was analysed. ResultsFive years after standard treatment for leprosy, erythema and vesicles appeared in the limbs without obvious inducement, and the disease became more and more severe. With clinical diagnosis and pathological examination, pemphigoid was confirmed, and the patients were given hormone treatment for leprosy reaction and anti-immunotherapy, as well as symptomatic supportive treatment. ConclusionLeprosy reaction and pemphigoid are both related to immunity, but the occurrence of both at the same time is relatively rare, so in the clinical process we should attach great importance to early detection, early diagnosis and prompt treatment to prevent further harm to the patient.