1. Diagnosis of leprosy The 3rd Cardinal sign
Salvatore Noto, Pieter A M Schreuder
Leprosy mailing list, May 2010
leprosy mailing list 1

2. The 3rd cardinal sign of leprosy
“Positive slit-skin smear”
leprosy mailing list 2

3. The slit and scrape method Technique of smear-taking from the ear lobe
Warning: the use of gloves is advised
Courtesy of B. Naafs

4. The slit and scrape method
Technique of smear-taking from the ear lobe 4
Courtesy of E Nunzi and A Clapasson
leprosy mailing list

5. The slit and scrape method
blade is then turned through
90 degrees
Warning: the use of gloves is advised
Courtesy of B. Naafs

6. Technique of smear-taking
Courtesy of E Nunzi and A Clapasson
leprosy mailing list 6

7. 4. Stain (Ziehl-Neelsen)
1. Smear
2. Dry
3. Fix
4. Stain (Ziehl-Neelsen)
Courtesy of E Nunzi
and A Clapasson
leprosy mailing list 7

8. Morphology Solid (S) Granular (G) Courtesy of A Clapasson
leprosy mailing list

9. Courtesy of A Clapasson
Granular (G)
Fragmented (F)

10. Bacteriological index (BI) = 4.83 + Morphological index (MI) = 6.1 %
Leprosy (LL)
Bacteriological index (BI) =
Morphological index (MI) = 6.1 %
left
right
Courtesy of S. Noto
leprosy mailing list

11. Leprosy (LL) = 4.7 + = 26.4 % Bacteriological index (BI)
Morphological index (MI)
= 26.4 %
Courtesy of S. Noto
leprosy mailing list 11