Medical Journal of Dr. D.Y. Patil University (Jan 2015)
An epidemiological and clinico-histopathological study of leprosy in semi-urban area under Pimpri Chinchwad Municipal Corporation in Pune district of Maharashtra
Abstract
Background: Despite having been declared eliminated in December 2005 from India as a public health problem, the prevalence of leprosy exceeds 1/10,000 population in certain districts/states of India. A spurt in its prevalence by 60% - from 0.74 to 1.18 within 1-year from 2012 to 2013 in the area under Pimpri Chinchwad Municipal Corporation (PCMC) of Pune district of Maharashtra, wherein our institution is located, motivated us to carry out this study. Aims and Objectives: This prospective study entailed recording of the epidemiological data of cases of leprosy and carrying out correlation of their clinical and histopathological diagnoses as per Ridley–Jopling scale along with inclusion of indeterminate and pure neuritic types. Materials and Methods: Eighty fresh untreated patients hailing from areas under PCMC–in whom leprosy was clinically considered to be either the diagnosis or the differential diagnosis-reporting to the department of dermatology of our tertiary care hospital were enrolled. Their age, sex, and clinical findings were recorded on a proforma. Slit skin and scrape smear were stained by the Ziehl–Neelsen method. Punch biopsies–processed and stained by hematoxylin and eosin and Fite-Faraco method for morphological assessment and identification of the lepra bacilli, respectively–were evaluated histopathologically and a clinico-histopathological correlation, attempted. Results: Male to female ratio of the study patients was 2.3:1; their age ranged from 14 to 74 (mean, 36.67) years. The overall clinico-histopathological concordance observed was 70%. Five cases of indeterminate leprosy (IL) emerged on histopathological examination from among the nine skin biopsies on patients of dermatoses mimicking leprosy (pityriasis alba, postinflammatory hypopigmentation, nevus depigmentosus, etc.). Conclusion: This study enabled us to detect additional cases of IL (from among dermatoses mimicking leprosy) and led to more accurate typing, thereby underscoring the importance of clinico-histopathological correlation as an important diagnostic aid.
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