Spectrum of Hansen's Disease with Clinicopathologic Correlation in a Tertiary Care Hospital

The sequence of Leprosy pathogenesis depends on the host-pathogen immunologic responses. The skin lesions may sometimes be missed, or mistaken for other common dermatoses clinically as well as histologically.

The study aims to observe the spectrum of Hansen's disease and different clinical patterns of Hansen's diagnosed in our hospital.

This was a retrospective study carried out in the department of pathology and dermatology at our hospital, from January 2014 to May 2016. In this period, 53 cases of clinically suspected Hansen's disease were biopsied. Routine hematoxylin and eosin staining along with special stain was done in all cases.

Out of 53 cases, 22 (41.50%) were borderline tuberculoid type, 8 cases (15.09%) were indeterminate type, borderline lepromatous were 5 (9.43%) and tuberculoid type, were 5 (9.43%). There were 7 cases (13.2%) which had doubtful clinical presentation of Hansen's disease but on biopsy were reported as nonspecific dermatitis in 6 patients and as normal findings in one patient. Hypopigmented macular lesions, hypoesthetic areas, nerve thickening and combination of the above were the most common clinical findings. Good correlation was seen between the clinical and histopathological findings in 33 cases (62.2%).

Histopathological examination of skin lesions is advisable for all suspected cases of leprosy. The early lesions of leprosy, especially the indeterminate type can have nonspecific findings in biopsy and nerve involvement has to be diligently searched for.