Clinico-pathological Correlation in Diagnosis of Hansen's Disease: A Histopathologist's Perspective

Kini, Reshma G; Choudhury, Hemangini

doi:10.5455/jihp.20161208123939

Cited by 3 publications

(5 citation statements)

References 6 publications

(11 reference statements)

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“…[ 6 ] The definitive diagnosis of IL depends on demonstration of nerve lesions and AFB, but can diagnosed even without finding a single bacillus, if clinical and histopathological features are suggestive, especially in endemic areas. [ 6 ] We found IL more on histopathology (33 cases) than clinically (23) similar to Kini and Chaudhary[ 4 ] [ Table 4 ].…”

Section: Discussionsupporting

confidence: 70%

“…Of the 207 patients diagnosed clinically as leprosy, biopsies showed evidence of leprosy in 189 cases with overall agreement 92.4% in the present study. Ridley and Jopling[ 10 ] found agreement between clinical and histological types in 68.3%, similarly Kini and Choudhary, 92.4%;[ 4 ] Mathur et al ., 80.4%;[ 11 ] Sharma and Rai, 85.8%;[ 12 ] and Murunantham et al ., 62.85%. [ 13 ]…”

Section: Discussionmentioning

confidence: 90%

“…In the present study, the most common clinical and histological subtype was BT, followed by TT similar to various studies in the literature. [ 4 6 15 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 20 ] Clinicopathological agreement of neuritic leprosy was 100% in our study similar to Kini and Choudhary. [ 4 ]…”

Section: Discussionmentioning

confidence: 99%

“…Due to its clinical diversity and ability to mimic other skin diseases, it is difficult to diagnose leprosy clinically in early stages. [ 4 ] Thus, histopathological examination of skin biopsies plays a pivotal role in early diagnosis, categorization, and treatment to prevent permanent nerve damage and Grade 2 deformities.…”

Section: Introductionmentioning

confidence: 99%

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A clinicohistopathological correlation of Hansen's disease in a rural tertiary care hospital of Central India

Atram

Ghongade

Gangane

2020

J Global Infect Dis

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Background: Leprosy is an ancient, chronic granulomatous infectious disease caused by Mycobacterium leprae , principally affecting the skin and peripheral nerves. The clinical manifestations of leprosy are variable and can mimic a variety of other skin diseases. Thus, histopathological examination plays an important role in early diagnosis and management. Aim: The aim was to study the clinicohistopathological correlation of all suspected cases of Hansen's disease. Materials and Methods: A retrospective study was conducted on 207 skin biopsies obtained from patients clinically diagnosed as new lesion of leprosy in the department of pathology from 2016 to 2019. Demographic, clinical details of the patients were retrieved from hospital information system. Hematoxylin–eosin- and Fite–Faraco-stained sections were evaluated for features confirming leprosy and further categorized as per Ridley–Jopling system. Sensitivity, specificity, and concordance rates were studied. Results: The male-to-female ratio was 1.5:1. The agreement between histopathological and clinical diagnoses was more than 90% in all the subclasses except for borderline tuberculoid leprosy (BT) and tuberculoid leprosy (TT) which showed an agreement of 86.5% and 88.4%, respectively. The sensitivity of clinical diagnosis ranged from 69.70% for indeterminate to 100% for histoid and neuritic types. The specificity ranged from 90% for BT and TT to 100% for neuritic leprosy. Conclusion: Clinical diagnosis of early leprosy lesions offers difficulties even to experienced dermatologists as a patient presents in different clinicopathological forms, depending on host immune status. Thus, the correlation between clinical, histopathological, and bacteriological features is required for diagnosis and classification of leprosy. Nerve damage is irreversible; therefore, early detection and treatment is important to prevent Grade 2 disabilities.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 90%

“…In the present study, the most common clinical and histological subtype was BT, followed by TT similar to various studies in the literature. [ 4 6 15 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 20 ] Clinicopathological agreement of neuritic leprosy was 100% in our study similar to Kini and Choudhary. [ 4 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A clinicohistopathological correlation of Hansen's disease in a rural tertiary care hospital of Central India

Atram

Ghongade

Gangane

2020

J Global Infect Dis

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A Histopathological Study of Leprosy Along With Clinical Correlation.

Vahini

Swathi

Umarani

et al. 2020

IJAR

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Background: Leprosy or Hansen’s disease is a chronic infectious disease that mainly affects skin and peripheral nerves. Histopathology and demonstration of lepra bacilli is an essential tool to supplement clinical examination and diagnosis for correct classification and therefore treatment of patients. Aim: To study histopathology of leprosy cases and identify histological types in patients in a tertiary care centre, Asram hospital in Eluru. Materials and Methods: 18 skin biopsies diagnosed as leprosy over a period of two years from January 2018 to December 2019 were studied. Haematoxylin-eosin and Fite-Faraco staining for demonstrating lepra bacilli were done. Results: Male to female ratio of patients was 4.5:1. Maximum number of cases was seen in the 3rd and fourth decades of life. The commonest histological type was borderline tuberculoid (5 cases, 28%) and indeterminate type, lepromatous type (3 cases, 16%); followed by tuberculoid leprosy and erythema nodosum leprosum (2 cases, 11%), the least common cases were of lepromatous leprosy to borderline tuberculoid leprosy (1cases, 6%). The most common site was upper limb (26%). All 3/18(24%) patients with affected nerves showed ulnar and auricular nerve involvement. Hypopigmented, anaesthetic plaque was the commonest clinical feature followed by erythematous lesions. All cases of borderline tuberculoid, borderline lepromatous, lepromatous, midboderline and indeterminate showed acid-fast bacilli on Fite stain. Tuberculoid cases showed well-formed granulomas, borderline tuberculoid type showed additional feature of giant cells and lepromatous types showed grenz zone and no granulomas. Conclusion: Histopathological examination is the gold standard for accurate diagnosis and typing of leprosy. It should be done in all leprosy cases presenting to the clinician.

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Histopathological Evaluation of Who Classified Multibacillary Leprosy Cases in a Tertiary Care Centre, South Kerala

Sanker

Nandakumar²,

Balkrishnan

2021

ijsr

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There are signicant differences in the histopathology of leprosy lesions which is inuenced by the host immune response to Mycobacterium leprae. Objective - To nd the histopathological changes in newly diagnosed multibacillary leprosy(MB) cases registered in the skin department Government Medical College, Thiruvananthapuram. Method- skin biopsy performed in 40 multibacillary leprosy cases and histopathological ndings were evaluated. 70% showed epidermal atrophy. Granulomas, composed of sheets of foamy macro Results- phages, lymphocytes and epithelioid cells, were seen in 21 cases & twenty two cases were AFB positive. Eight cases each were lepromatous, borderline tuberculoid, mid boderline, borderline lepromatous types. Conclusion- Presence of 60% cases of borderline leprosy indicates the unstable immune response in leprosy patients. Majority were either borderline lepromatous or lepromatous showing the infective nature of multibacillary leprosy. Histopathological examination with Fite- Foroco staining is a crucial method and the gold standard for accurate diagnosis and typing of leprosy.

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Clinico-pathological Correlation in Diagnosis of Hansen's Disease: A Histopathologist's Perspective

Cited by 3 publications

References 6 publications

A clinicohistopathological correlation of Hansen's disease in a rural tertiary care hospital of Central India

A clinicohistopathological correlation of Hansen's disease in a rural tertiary care hospital of Central India

A Histopathological Study of Leprosy Along With Clinical Correlation.

Histopathological Evaluation of Who Classified Multibacillary Leprosy Cases in a Tertiary Care Centre, South Kerala

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