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IP Indian Journal of Clinical and Experimental Dermatology


Clinicohistopathological correlation in leprosy: A study at a rural based tertiary care centre, Gujarat


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Author Details: Rita Vipul Vora, Nilofar Gulamsha Diwan, Nidhi Hemant Patel, Rochit Rajesh Singhal, Pragya Ashok Nai

Volume : 2

Issue : 1

Online ISSN : 2581-4729

Print ISSN : 2581-4710

Article First Page : 23

Article End Page : 26


Abstract

Context: Leprosy is a chronic infectious disease involving skin and peripheral nerves. It is present in different clinico-pathological forms depending upon immune status of the host. This study has been conducted to know the correlation between clinical and histopathological diagnosis of leprosy. Polar group gives good clinical and histopathological correlation while borderline groups show discordance between clinical and histopathological diagnosis.
Aims: To study the clinical and histopathological features in patients of leprosy and to find out the correlation of clinical diagnosis and histopathological diagnosis.
Setting and Design: Prospective, Observational.
Material and Method: The study was carried out in the department of dermatology at a tertiary care centre of Gujarat for a duration of 3 years from November 2012 to November 2015 after ethical clearance from institutional ethics committee. All the patients who were suspected as leprosy clinically were enrolled in a predesigned proforma after written informed consent and were subjected to histopathological examination.
Results: A total of 119 patients were enrolled in which the majority of patients were in the age group of 20-40years 57(47.89%). 77(64.70%) were males and 42(35.29%) were females.  Maximum number of patient clinically belonged to tuberculoid leprosy in 31(26.05%) cases. Histologically, tuberculoid leprosy was the most common type in 32(26.89%) cases. Maximum clinico-histopathological correlation was seen in IL (100%) followed by TT (83.87%), BL (63.15%), LL (56.25%), BT (27.58%) and minimum in BB (0%). Overall concordance of diagnosis was seen 53.78%.
Conclusion: The histopathological features in leprosy indicate the accurate response of the tissues while the clinical features indicate only the morphological changes due to underlying pathology. Thus, it is logical to expect some disparity between the clinical and histopathological features. The classification of leprosy requires attention to the histopathological criteria and correlation with clinical information so as to facilitate accurate therapy according to proper treatment category and to prevent undesirable complications.

Keywords
: Leprosy, clinical features, histopathology.
Key message: It is sometimes very difficult on clinical grounds to diagnose leprosy due to its varied presentation and it can also mimic various other diseases therefore histopathological examination is needed to confirm diagnosis clinically for proper treatment category and decrease the burden of the disease in the society