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Clinico-Histopathological correlation of leprosy: A retrospective study of skin biopsy specimens in Chitwan Medical College

Tiwari M,1 Ranabhat S,1 Maharjan S2


Associate Professor,1 Assistant Professor2

1-3Department of Pathology, Chitwan Medical College, Chitwan, Nepal

ABSTRACT
AimAim of this study was to find out cases of leprosy diagnosed in skin biopsy specimen and to study clinicohistopathological correlation in diagnosis of leprosy.

Background

Leprosy is caused by Mycobacterium leprae. There are various clinico-pathological forms of leprosy depending on the immune status of the host. Diagnosis of leprosy can be done by clinical, microbiological and histopathological examination. Histopathological examination is considered as
important for confirmatory diagnosis, for assessment of regression of the disease in patient under treatment and also for research purposes. Number of skin lesions in patients, Ridley and Jopling (RJ) classification and bacilliary index in histological sample all can be correlated for proper classification and treatment of leprosy cases.

Materials and Methods

This retrospective study included cases of leprosy diagnosed in skin biopsy specimen in the Department of Pathology of Chitwan Medical College from April 2009 to March 2014. Clinical diagnosis was correlated with that of histopathological diagnosis.

Results

In this study, male to female ratio was 1.4:1. Mean age of patients was
32.66 years. Most common lesion was hypopigmented macule (68%). On the basis of RJ scale, maximum cases (41%) were classified as borderline tuberculoid leprosy (BT) and least number (3.7%) as leprosy, and polar lepromatous leprosy. Maximum clinico-histopathological correlation was seen in borderline lepromatous leprosy (87.5%) followed by BT (68.1%). Fite ferraco stain was done in only 27 cases. It was 0-2 in tuberculoid spectrum and >2 in lepromatous spectrum.

Conclusion

Combining clinical, histopathological and microbiological diagnosis of leprosy is important for
proper treatment of the patient and prevention of complications.

KEY WORDS
Bacillary index, macules, Mycobacterium leprae, Ridley and Jopling classification

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