CLINICO – HISTOPATHOLOGICAL CORRELATION IN LEPROSY: A TERTIARY CARE HOSPITAL BASED STUDY

• Main Authors: Deeptara Pathak Thapa, Anil Kumar Jha
• Format: Article
• Language: English
• Published: Our Dermatology Online 2013-07-01
• Series: Nasza Dermatologia Online
• Subjects: histopathology; leprosy; granuloma
• Online Access: http://www.odermatol.com/issue-in-html/2013-3-7-clinico/

Introduction: Leprosy is a chronic infectious disease affecting mainly cutaneous and peripheral nervous system. Histopathology is an important tool to diagnosis leprosy in situation where it mimics other clinical condition. This study was conducted to know the correlation between clinical and histopathological diagnosis of Leprosy. Material and Methods: This was a retrospective study and patients were enrolled in whom leprosy was clinically diagnosed or suspected and histo-pathological examinations were carried upon. Results: A total of 71 patients were studied. Of them 48 patients (67.6%) were males and rest 23 (32.39%) patients were females. Mean age of patients at presentation was 37.85 +/- 2.021 years. Clinically in 42 patients (59.1%) type of leprosy could not be specified. Borderline tuberculoid was diagnosed in 7 patients (9.8%), Tuberculoid in 6(8.5%), Relapse in 3(4.2%), lepromatous in 6(8.5%) and Borderline, borderline lepromatous 1(1.4), Indeterminate 1 patient (1.4%). In 7% cases, Hansens disease was considered as differential diagnosis along with other clinical conditions. In 47% cases, data was not available. On histopathological evaluation on skin biopsies, epidermal changes seen were 29.5%. Of the total 71 patient, dermal changes seen were granuloma (42%), dermal infiltrate (11%), adnexal infiltrate (7%), nerve infiltrate (11%), adnexal with nerve infiltrate (6%), perivascular with adnexal infiltrate (20%) and nonspecific (3%). Dermal infiltrates in 46.4% cases constituted of lympho-histiocytes. In 48 patients (69%) leprosy was histopathologically confirmed and in rest 31% cases diagnoses was non-specific in 20 patients (28.1%), vasculitis, Dariers and Fungal infection 1 patient each (1.4%). Borderline Tuberculoid (BT) and TT was the most common diagnosis among leprosy patients around 29.2% each, followed by Indeterminate 25%, LL 8.3%, BL and and Pure neural 4.1% each. When clinical diagnosis and histopathological diagnosis was correlated it was found that the parity was seen in TT as 66.6%, BT 42.9%, LL 16.7%. Where Hansen’s disease was kept as differential diagnosis two patients had leprosy. Conclusion: The study being retrospective the uniformity in clinical diagnosis and histopathological evaluation couldnot be assessed. With the limitations this study still give information about the importance of histopathology to diagnose Leprosy and for proper treatment category and decrease the burden of the disease in the society.