Slit skin smear versus anti-phenolic glycolipid-I serology in diagnosis of leprosy: a cross sectional study

Leprosy is a chronic infectious disease which mainly affects the skin, nasal mucosa, and peripheral nerves. The aim of this study was to compare between the efficacies of serum anti-phenolic glycolipid 1 (APGL-I) level versus slit skin smear (SSS) in diagnosis of leprosy. This study involved 58 leprosy cases who were clinically examined, slit-skin smears were taken from all at diagnosis from four sites and APGL-I levels were seroassayed using ELISA. The mean age of studied group was 39.42 +/- 15.2, 44.8% of patients were males and 55.2% were females. The majority of patients (72.4%) had multibacillary leprosy (MBL) followed by (27.6%) of patients had paucibacillary leprosy (PBL). SSS had sensitivity of 71.5% and specificity of 84% (area under curve; AUC = 0.763, 95% CI 0.427-0.823) while APGL-I had a sensitivity of 80% and specificity of 85% (area under curve; AUC = 0.830, 95% CI 0.424-0.852). Both serum Anti-PGL-1 levels and slit skin smear are useful in diagnosing leprosy, but their effectiveness depends on disease stage and patient's immune response. Being inexpensive, easy and noninvasive technique, APGL1 can be an adjunct method for the detection of leprosy in the population while slit skin smear having higher specificity. Combining both methods or using sequential diagnostic approaches could enhance accuracy and reduce missed diagnoses.