Histopathological panoroma and clinocopathological correlation of Hansen’s disease in tertiary care hospital

Abstract

Background: The present study was undertaken to study the histopathological features of leprosy in skin punch biopsies and to categories them in to various type based on microscopy and bacterial index. The aim of study was to know the role of histopathology in diagnosis of Hansen’s disease and to study the clinicohistopathological correlations of suspected cases of Hansen’s disease. Materials and methods: A retrospective hospital-based study of clinically diagnosed leprosy cases was conducted over a period of one year (April 2021 to March 2022). Lesional skin biopsies obtained were fixed, processed and stained with Haematoxylin and Eosin (H&E) followed by Fite-Faraco staining. The lesions were classified on microscopy as per Ridley-Jopling classification. Results: 63 Skin biopsies were obtained from patients with age range of 14-72 years. Highest incidence was in age group of 31 – 50 years. There was male predominance with male to female ratio of 2:1. Clinically borderline Hansen’s (BB) (25.40%) was the most frequent subtype observed followed by borderline lepromatous (BLH) (19.04%) and lepromatous Hansen’s (LL) (19.04%). On histopathology we found tuberculoid Hansen’s (TT) (28.57%) was the most frequently observed subtype followed by borderline tuberculoid Hansen’s (BT) (19.04%). Fite stain revealed lepromatous bacilli in all cases of LL, BL, histoid and indeterminate Hansen’s; whereas bacilli could be demonstrated in six cases of BB, eight cases of BT and two cases of TT. Conclusion: Early diagnosis of leprosy is clinically difficult as patient present in different clinicopathological form, depending on host immune status. Therefore combined clinical, histopathological and bacteriological features are required for accurate diagnosis and classification.

Keywords

• hansen’s disease
• histopathology
• bacterial index
• clinico-pathological correlation