Clinico-Pathological Correlation in Classification of Leprosy

Abstract

Background: Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae. It is a leading cause of permanent disability. Most commonly seen in tropical countries. India represents two thirds of the global burden. A total of nearly 3000 new cases were detected in Karnataka in 2017-2018. Out of them 5% presented with grade II disability. It affects mainly the skin, nasal mucosa, and peripheral nerves. Aim: To study and categorise types of leprosy histomorphologically and correlate them clinically. Materials and Methods: Skin biopsies of suspected leprosy cases were received in the department of pathology, from April 2017 to March 2019 for a period of two years. Relevant clinical ndings were taken. A total of 30 cases of leprosy were diagnosed. They were classied histopathologically using modied Ridley–Jopling's classication. Total Results: number of cases studied were 30. Age group was found to be 20-70 years. Clinically patients presented commonly with hypo-anaesthetised, hypopigmented patches and nodules. 16 cases were of lepromatous leprosy, 2 cases of Borderline lepromatous leprosy, 2 cases of Borderline leprosy, 2 cases of Borderline tuberculoid leprosy, 6 cases of Tuberculoid leprosy and 2 Cases were of Erythema nodosum leprosum. Conclusion: Lepromatous leprosy is the most common type in present study. Correlation between clinical, bacteriological, and morphological features is required for accurate classication of Hansen's disease. Clinical detection and morphological diagnosis of early lesions remain challenging, and the histological ndings should always be interpreted in correlation with clinical ndings. Histopathological examination is the gold standard to diagnose and categorise leprosy to start appropriate treatment.