Assessment of neuropathic pain in leprosy patients with relapse or treatment failure by infrared thermography: A cross-sectional study.

<h4>Background</h4>Neuropathic pain (NP) is one of the main complications of leprosy, and its management is challenging. Infrared thermography (IRT) has been shown to be effective in the evaluation of peripheral autonomic function resulting from microcirculation flow changes in painful s...

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Autores principales:	Liliane Marques de Pinho Tiago, Diogo Fernandes Dos Santos, Douglas Eulálio Antunes, Letícia Marques Pinho Tiago, Isabela Maria Bernardes Goulart
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/69a063b7bcf5428a95643ca730d70588
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spelling	oai:doaj.org-article:69a063b7bcf5428a95643ca730d705882021-12-02T20:24:03ZAssessment of neuropathic pain in leprosy patients with relapse or treatment failure by infrared thermography: A cross-sectional study.1935-27271935-273510.1371/journal.pntd.0009794https://doaj.org/article/69a063b7bcf5428a95643ca730d705882021-09-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009794https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Neuropathic pain (NP) is one of the main complications of leprosy, and its management is challenging. Infrared thermography (IRT) has been shown to be effective in the evaluation of peripheral autonomic function resulting from microcirculation flow changes in painful syndromes. This study used IRT to map the skin temperature on the hands and feet of leprosy patients with NP.<h4>Methodology/principal findings</h4>This cross-sectional study included 20 controls and 55 leprosy patients, distributed into 29 with NP (PWP) and 26 without NP (PNP). Thermal images of the hands and feet were captured with infrared camera and clinical evaluations were performed. Electroneuromyography (ENMG) was used as a complementary neurological exam. Instruments used for the NP diagnosis were visual analog pain scale (VAS), Douleur Neuropathic en 4 questions (DN4), and simplified neurological assessment protocol. The prevalence of NP was 52.7%. Pain intensity showed that 93.1% of patients with NP had moderate/severe pain. The most frequent DN4 items in individuals with NP were numbness (86.2%), tingling (86.2%) and electric shocks (82.7%). Reactional episodes type 1 were statistically significant in the PWP group. Approximately 81.3% of patients showed a predominance of multiple mononeuropathy in ENMG, 79.6% had sensory loss, and 81.4% showed some degree of disability. The average temperature in the patients' hands and feet was slightly lower than in the controls, but without a significant difference. Compared to controls, all patients showed significant temperature asymmetry in almost all points assessed on the hands, except for two palmar points and one dorsal point. In the feet, there was significant asymmetry in all points, indicating a greater involvement of the lower limbs.<h4>Conclusion</h4>IRT confirmed the asymmetric pattern of leprosy neuropathy, indicating a change in the function of the autonomic nervous system, and proving to be a useful method in the approach of pain.Liliane Marques de Pinho TiagoDiogo Fernandes Dos SantosDouglas Eulálio AntunesLetícia Marques Pinho TiagoIsabela Maria Bernardes GoulartPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 9, p e0009794 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Liliane Marques de Pinho Tiago Diogo Fernandes Dos Santos Douglas Eulálio Antunes Letícia Marques Pinho Tiago Isabela Maria Bernardes Goulart Assessment of neuropathic pain in leprosy patients with relapse or treatment failure by infrared thermography: A cross-sectional study.
description	<h4>Background</h4>Neuropathic pain (NP) is one of the main complications of leprosy, and its management is challenging. Infrared thermography (IRT) has been shown to be effective in the evaluation of peripheral autonomic function resulting from microcirculation flow changes in painful syndromes. This study used IRT to map the skin temperature on the hands and feet of leprosy patients with NP.<h4>Methodology/principal findings</h4>This cross-sectional study included 20 controls and 55 leprosy patients, distributed into 29 with NP (PWP) and 26 without NP (PNP). Thermal images of the hands and feet were captured with infrared camera and clinical evaluations were performed. Electroneuromyography (ENMG) was used as a complementary neurological exam. Instruments used for the NP diagnosis were visual analog pain scale (VAS), Douleur Neuropathic en 4 questions (DN4), and simplified neurological assessment protocol. The prevalence of NP was 52.7%. Pain intensity showed that 93.1% of patients with NP had moderate/severe pain. The most frequent DN4 items in individuals with NP were numbness (86.2%), tingling (86.2%) and electric shocks (82.7%). Reactional episodes type 1 were statistically significant in the PWP group. Approximately 81.3% of patients showed a predominance of multiple mononeuropathy in ENMG, 79.6% had sensory loss, and 81.4% showed some degree of disability. The average temperature in the patients' hands and feet was slightly lower than in the controls, but without a significant difference. Compared to controls, all patients showed significant temperature asymmetry in almost all points assessed on the hands, except for two palmar points and one dorsal point. In the feet, there was significant asymmetry in all points, indicating a greater involvement of the lower limbs.<h4>Conclusion</h4>IRT confirmed the asymmetric pattern of leprosy neuropathy, indicating a change in the function of the autonomic nervous system, and proving to be a useful method in the approach of pain.
format	article
author	Liliane Marques de Pinho Tiago Diogo Fernandes Dos Santos Douglas Eulálio Antunes Letícia Marques Pinho Tiago Isabela Maria Bernardes Goulart
author_facet	Liliane Marques de Pinho Tiago Diogo Fernandes Dos Santos Douglas Eulálio Antunes Letícia Marques Pinho Tiago Isabela Maria Bernardes Goulart
author_sort	Liliane Marques de Pinho Tiago
title	Assessment of neuropathic pain in leprosy patients with relapse or treatment failure by infrared thermography: A cross-sectional study.
title_short	Assessment of neuropathic pain in leprosy patients with relapse or treatment failure by infrared thermography: A cross-sectional study.
title_full	Assessment of neuropathic pain in leprosy patients with relapse or treatment failure by infrared thermography: A cross-sectional study.
title_fullStr	Assessment of neuropathic pain in leprosy patients with relapse or treatment failure by infrared thermography: A cross-sectional study.
title_full_unstemmed	Assessment of neuropathic pain in leprosy patients with relapse or treatment failure by infrared thermography: A cross-sectional study.
title_sort	assessment of neuropathic pain in leprosy patients with relapse or treatment failure by infrared thermography: a cross-sectional study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/69a063b7bcf5428a95643ca730d70588
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Assessment of neuropathic pain in leprosy patients with relapse or treatment failure by infrared thermography: A cross-sectional study.

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