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Tiago LMP, Santos DFD, Antunes DE, et al. Assessment of neuropathic pain in leprosy patients with relapse or treatment failure by infrared thermography: A cross-sectional study. PLoS Negl Trop Dis. 2021;15(9):e0009794doi: 10.1371/journal.pntd.0009794.
Tiago, L. M. P., Santos, D. F. D., Antunes, D. E., Tiago, L. M. P., & Goulart, I. M. B. (2021). Assessment of neuropathic pain in leprosy patients with relapse or treatment failure by infrared thermography: A cross-sectional study. PLoS neglected tropical diseases, 15(9), e0009794. https://doi.org/10.1371/journal.pntd.0009794
Tiago, Liliane Marques de Pinho, et al. "Assessment of neuropathic pain in leprosy patients with relapse or treatment failure by infrared thermography: A cross-sectional study." PLoS neglected tropical diseases vol. 15,9 (2021): e0009794. doi: https://doi.org/10.1371/journal.pntd.0009794
Tiago LMP, Santos DFD, Antunes DE, Tiago LMP, Goulart IMB. Assessment of neuropathic pain in leprosy patients with relapse or treatment failure by infrared thermography: A cross-sectional study. PLoS Negl Trop Dis. 2021 Sep 23;15(9):e0009794. doi: 10.1371/journal.pntd.0009794. eCollection 2021 Sep. PMID: 34555035; PMCID: PMC8491942.
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PLoS Negl Trop Dis. 2021 Sep 23;15(9):e0009794. doi: 10.1371/journal.pntd.0009794. eCollection 2021 Sep.

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

PLoS neglected tropical diseases

Liliane Marques de Pinho Tiago, Diogo Fernandes Dos Santos, Douglas Eulálio Antunes, Letícia Marques Pinho Tiago, Isabela Maria Bernardes Goulart

Affiliations

  1. National Reference Center for Sanitary Dermatology and Leprosy, Clinical Hospital, Federal University of Uberlandia, Uberlândia, Brazil.
  2. Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Uberlandia, Uberlândia, Brazil.
  3. Graduate Program in biomedical engineering, Faculty of Electrical Engineering, Federal University of Uberlandia, Uberlândia, Brazil.

PMID: 34555035 PMCID: PMC8491942 DOI: 10.1371/journal.pntd.0009794

Abstract

BACKGROUND: 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.

METHODOLOGY/PRINCIPAL FINDINGS: 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.

CONCLUSION: 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.

Conflict of interest statement

The authors have declared that no competing interests exist.

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