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
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.