Clinico pathological correlation of leprosy: A 4 years retrospective study from a tertiary referral centre in north India

Leprosy is a chronic infectious disease caused by Mycobacterium leprae that primarily affects the skin and nerves. The histopathological findings in leprosy are related to the immunological status of the patient.

To tabulate the incidence of different clinical and pathological patterns of leprosy and establish their correlation.

A total of 118 consecutive skin biopsies of leprosy patients were studied in the Department of Pathology over 4 year duration (2010 – 2014). A Ridley-Jopling criterion was used for the diagnosis and classification of the disease. All biopsies were stained with H&E and Fite Faraco. Clinicohistopathological correlation was calculated using percentage values.

A total of 118 cases of leprosy were studied out of which 76 were males. The age of the patients ranged from 8 years to 76 years. Majority were in the 31–40 year age group (n= 52.44%). Both clinically (n=55, 46.6%) and histologically (n=41, 34.7%), the maximum patients were in the BT category. Histopathologically LL (21.2%) and BB (16.1%) were the other common groups. The overall concordance between clinical and histopathological classification was 61.8%. Maximum concordance was seen in LL (79.2%) & TT (72.7%). The concordance was lower in borderline groups and least in BL (18.7%). Fite Faraco stain demonstrated acid fast bacilli in 28 cases (23.7%).

The clinicohistopathological correlation is best at the polar ends of spectrum as compared to borderline cases. Histopathology remains the most powerful indicator of shift in patient's immune status.