Demographic profile and clinicopathologic concordance of leprosy in the North‐West part of Rajasthan, India: A 2 years prospective study

Abstract

Background: Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae principally
affecting the skin and peripheral nerves. M. leprae is an obligate intracellular bacillus (0.3–1 μ wide and
1–8 μ long) that is acid‐fast. Leprosy exhibits a spectrum of clinical characteristics that correlate with
the histopathological changes and the immunological status of the individual. There is a range of varied
clinicopathologic manifestations, and the diagnosis is made from adequate clinical information combined
with histopathology. The aim of the study was to classify leprosy according to the Ridley–Jopling classification
and perform the clinicopathological correlation.
Materials and Methods: Aprospective study was conducted on 184 cases of skin biopsies clinically diagnosed with
leprosy, received in the Department of Pathology, Government Medical College, Kota from July 2015 to July 2017.
Adequate clinical history was taken and biopsies were stained with hematoxylin and eosin and modified Fite
Faraco stain. The Ridley and Jopling classification was followed in both clinical and histopathological diagnosis.
Results: This study included 184 patients diagnosed clinically with leprosy. Skin biopsy revealed evidence
of leprosy in 158 cases. A maximum number of patients clinically belonged to indeterminate leprosy which
constituted 57 (30.9%) cases followed by borderline tuberculoid (BT) 41 cases (22.2%). On the contrary,
histologically, although indeterminate leprosy was the most common with 51 cases (32.2%), the second
most common was borderline lepromatous (BL) with 28 cases (17.7%) cases. Twenty‐six cases of clinically
diagnosed leprosy showed no features of leprosy histologically. The clinical and histopathological correlation
was seen in 158 cases (85.3%the). The correlation was highest in BL (89.2%) followed by lepromatous and
BT leprosy. Fite‐Farraco stain was positive in 85 cases (53.7%).
Conclusion: The classification of leprosy requires attention to the histopathological criteria and correlation
with clinical information and bacteriological examination to facilitate accurate therapy.