Title: Clinico-Histopathological Correlative Study of Leprosy at a Rural Hospital

Authors: Dr Deepa Tekwani, DCP, DNB (Pathology) , Dr Vaibhav Patil, MD (Pathology), Dr Ram Joshi, MD (Medicine), Dr Sneha Joshi, MD (Pathology)

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i5.203

Abstract

Objectives      

1.      To analyze the clinico-histopathological correlation in different types of leprosy.

2.      To study histopathological spectrum of skin lesions in leprosy.

3.      To observe disparity between clinical and histopathological features in different types of leprosy.

Methods: The history and complete clinical examination of 197 patients coming to Dr. Bhausaheb Sardesai Hospital,Talegaon-Dabhade  was noted, with reference to skin lesions, nerves and sensory disturbances. Relevant past and family history was taken. Biopsies were taken from most active skin lesions including margins of lesion by Department Of Dermatology & samples were sent to the Department Of Pathology in 10% formalin. The tissue section was stained routinely by Hematoxylin and Eosin. Special stain like Modified Fite Faraco was done to demonstrate lepra bacilli. Histopathological findings were graded into Tuberculoid (TT), Borderline-Tuberculoid (BT), Midborderline (BB), Borderline-Lepromatous (BL), and Lepromatous (LL), according to Ridley and Jopling scale. Clinico-Histopathological correlation was done.

Results: Out of 197 suspected cases of Leprosy which are biopsied, 135(68.52%) cases showed histological features consistent with one type of leprosy.  A comparison of histopathological findings with that of clinical pattern revealed that maximum correlation was seen with TT(83.33%) followed by BT(79.76%), BL(54.16%), LL(50%) & BB(25%). There were 3 cases of Histoid Leprosy which showed 100% correlation.

Conclusions: As there can be some degree of overlap between different types of leprosy, both clinically and histopathologically, correlation of clinical and histopathological features along with bacteriological index appears to be more useful for accurate typing of leprosy than considering any one of the single parameters alone.

Key Words: Leprosy, BT, BL,TT,LL.

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Corresponding Author

Dr Deepa Tekwani

Plot no 237, Santosh Nivas, Near Ganpati Mandir

River Road, Pimpri, Pune-411017