ABSTRACT
Background: Leprosy or Hansen抯 disease caused by Mycobacterium leprae is a chronic granulomatous disease characterized by hypoesthetic skin lesions and nerve involvement. The objective of the study was to find clinicohistopathological correlation of Hansen抯 disease diagnosed at a tertiary care centre of eastern India. Material and Methods: Hospital based retrospective study was conducted that included cases of leprosy diagnosed clinically and examined for histopathology at Indira Gandhi Institute of Medical Sciences, Patna from January 2021 to December 2021. Clinical diagnosis was correlated with that of histopathological diagnosis. Result: From this study, it was observed that, the commonest age group affected by leprosy was 20 to 40 years, males were more commonly affected than females (M:F = 1.83: 1) and commonest clinically diagnosed spectrum was Tuberculoid leprosy (TT) ( 48.03%). It was observed that there was complete agreement between clinical diagnosis and histopathological diagnosis in 84.3% cases and disagreement was observed in 15.7% cases. Conclusion: Combining clinical, and histopathological finding of leprosy is essential for accurate diagnosis and thus proper treatment of the patient and prevention of complications.
ABSTRACT
Leprosy is a chronic disease of ancient world and is still afflicting patients in many parts of world mainly Asia and Africa. Leprosy is one of the most dreaded diseases of humankind. We wanted to study the various microscopic patterns and subtypes of Leprosy. We also wanted to study the Bacterial Index in the region of Sawangi, Meghe.METHODS80 skin biopsies after adequate fixation in 10% of formalin, were routinely processed and were stained with H and E, Fite-Faraco stain and Modified Rapid Acid-Fast Bacilli (MRAFB staining) method, were studied microscopically and bacterial index was calculated.RESULTSA total of 80 skin biopsies were obtained from patients of department of dermatology over a period of two years from 2017 to 2019. Among them Lepromatous leprosy were 43 cases, Tuberculoid leprosy were 23 cases, Borderline lepromatous leprosy were 09 cases, Borderline tuberculoid leprosy were 03 cases, histoid leprosy were 01 case and ENL were 01 case. With an age range of 6 - 85 years, majority were in 31-40 years of age group, with male to female ratio of 2.47:1. LL was the most common type of leprosy (53.75%).CONCLUSIONSAccurate diagnosis of leprosy purely on clinical grounds is extremely difficult. Hence, there can be false positive and false negative diagnosis. Since histopathology is confirmatory, with application of Fite-Faraco and MRAFB staining it can also evaluate the bacterial load. Hence in all suspected cases of leprosy, histopathology along with Fite-Faraco and MRAFB staining should compulsorily be done.
ABSTRACT
Introduction: Leprosy, caused by Mycobacterium leprae, is widely prevalent in India and presents with different subtypes. However, there exists a great variation in the interpretation of clinical and histopathological examination of these lesions. The present study was carried to correlate clinical diagnosis of leprosy cases with histopathological diagnosis. Methodology: A retrospective Hospital-based study was conducted in patients of Leprosy, who attended Dermatology Out Patient Department for a period of 18 months. Clinical diagnosis was noted and the biopsies were processed as per standard protocol in the Department of Pathology. The clinical and histopathological concordance was calculated using percentage parity. Results & Conclusion: In a total of 52 cases, 29(55.7%) were males and 23(44.2%) were females. The histopathological diagnoses from our study showed agreement with clinical diagnoses in 27 (57.69%) cases. Clinico-histopathological agreement was noted maximum in LL (80%), followed by BT (57.14%), BL (50 %), BB (50%), TT (46.2 %), and least in IL (42.8 %).
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.