National Journal of Laboratory Medicine (Jul 2021)
Clinico-Pathological Study of LeprosyA 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 into various types of lesions according to Ridley Jopling classification. Materials and Methods: The descriptive study included clinically diagnosed 183 leprosy cases which 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 hematoxylin and eosin and Fite-faraco stain. Ridley-Jopling classification was made to classify leprosy. Clinical diagnosis was in concordance with that of histopathological diagnosis. Results: A total of 183 skin biopsies were studied from patients with 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, maximum 78 cases (42.6%) were diagnosed as Borderline Tuberculoid (BT) leprosy followed by indeterminate leprosy 34 (18.57%). On histopathological examination also maximum cases were BT leprosy 64 (82.05%) followed by Tuberculoid (TT) leprosy 13 (81.25%). Fite-faraco stain was done in 71 cases and 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, histopathological examination along with special stain is essential for proper diagnosis and treatment of the patient as well as prevention of its complication.
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