ABSTRACT
Clinical diagnosis of early leprosy lesions poses difficulties. The present study was carried to correlate histological diagnosis of skin biopsies of untreated leprosy cases with clinical diagnosis using Ridley- Jopling classification. 270 skin biopsies of untreated leprosy cases over a period of two years were included . Paraffin sections of biopsies were stained with Hematoxylin & Eosin, Ziehl-Neelsen’s & Fite’s stains, examined and classified histopathologically according to Ridley- Jopling scale and then correlated with clinical diagnosis. Overall concordance of clinical and histopathological diagnosis was seen in 53.44% cases with maximum parity in lepromatous leprosy (75.86%), followed by borderline lepromatous (58.82%), borderline tuberculoid (53.01%), tuberculoid (47.37%), and least in mid-borderline cases (37.35%). Indeterminate leprosy cases showed 100% clinicopathological concordance. There was minor disagreement (difference of one group) in 29.56% and major disagreement (difference of two or more groups) in 17% cases. We noted minor disagreement in polar leprosy (TT+LL) and major discordance in borderline group (BT+BB+BL). Cases in borderline group are in continuously changing immunological spectrum and histological classification because of its definitve features gives a better indication than clinical classification for any recent shift of a case in the spectrum. Skin biopsy may be studied in all cases of leprosy for better diagnosis.