Clinico-pathological Study of Leprosy- A Descriptive Study

Abstract

Introduction: Leprosy is an age old disease affecting mankind with various clinico-pathological forms. Mycobacterium Leprae causes a chronic infectious disease known as Leprosy or Hansen’s disease. It remained a major public health issue due to associated case load, morbidity and stigma attached to it. Clinical and histopathological examination along with demonstration of lepra bacilli in skin smears by Fite-faraco stain and Bacillary Index (BI) is widely used for proper classification and diagnosis of leprosy. Aim: To study the clinico-pathological features of leprosy in skin biopsies and to categorise it into various types of lesions according to Ridley Jopling classification. Materials and Methods: The descriptive study included clinically diagnosed 183 leprosy cases who underwent skin biopsy for histopathological examination from January 2017 to December 2018 at Shri Bhausaheb Hire Government Medical College Dhule, Maharashtra. All sections were stained with Haematoxylin and Eosin (H&E) and Fite-faraco stain. Ridley-Jopling classification was done to classify leprosy. Clinical diagnosis was in concordance with that of histopathological diagnosis. Results: A total of 183 skin biopsies were studied from patients in an age group of 11-76 years. Male to female ratio was 1.5:1 and commonest age group affected was 21-40 years. Clinically, 78 cases (42.6%) were diagnosed as Borderline Tuberculoid (BT) leprosy followed by indeterminate leprosy 34 (18.57%). On histopathological examination maximum cases had BT leprosy 64 (82.05%) followed by Tuberculoid (TT) leprosy 13 (81.25%). Fite- faraco stain was done in 71 cases and was found positive in all cases of Borderline Lepromatous (BL) and Lepromatous Leprosy (LL). Also,concordance between Bacillary Index (BI) and histopathology examination was done. The clinico-histopathological concordance was seen in 127 cases (69.39%). Conclusion: Early and accurate diagnosis by clinical and histopathological examination along with special stain is essential for proper diagnosis and treatment of the patient as well as prevention of its complications.