The bacteriological status of leprosy patients is usually assessed by the slit-skin
smear method introduced by Wade. So, bacteriological index (BI) was calculated by this
method taken from both eye brows, both ear lobes, the chin, both legs, the dorsal
surfaces of the middle and terminal phalanges of the middle finger of both hands, the
dorsal surfaces of the middle and terminal phalanges of the second toe of both feet and
the nasal mucosa in 39 lepromatous leprosy patients who have been treated with
antileprosy chemotherapy regularly or irregularly. The bacterial indices from the 16 sites
were compared.
(1) In tow long treated smear negative case, the terminal phalanges of the fingers
proved to be the only skin sites positive for bacilli, all other routine sites, being
acid-fast bacilli negative.
(2) The individual mean value of BI of the dorsum of the middle and terminal
phalanges of the middle finger of both hands and the dorsum of the middle and terminal
phalanges of the second toe of both feet was not significantly different.
(3) In 35 out of 39 cases, the BI at the finger was more productive than that at the
nasal mucosa and in 26 out of 39 cases, the BI at the toe was more productive than
that at the nasal mucosa, i. e. , the BI at the finger and the toe was not less than that
at the nasal mucosa.
(4) The mean value of BI of the nine sites was 2.73 in the eye brow, 2.66 in the ear
lobe, 2.62 in the lower leg, 2.48 in the chin and the dorsal surfaces of the terminal
phalanges of the middle finger of both hands, 2.43 in the dorsal surfaces of the middle
phalanges of the middle finger of both hands, 2.38 in the dorsal surfaces of the terminal
phalanges of the second toe of both feet and 2.17 in the dorsal surface of the middle
phalanges of the second toe of both feet.
We thought that it was much resonable to include the middle finger and the second
toe as routine sites for slit-skin smear for M. Leprae identification.
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