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Published on: July 15, 2011
Clinicohistopathological correlation in leprosy
M C Mathur1, R B K Ghimire, P Shrestha
1Department of Dermatology, College of Medical Sciences, Bharatpur, Chitwan, Nepal.
Background:
Leprosy is a chronic, infectious disease caused by Mycobacterium leprae. It is classified into five groups based on clinical, histological, microbiological and immunological criteria (Ridley and Jopling Classification) . However, a great variation has been observed in the interpretation of histopathological examination ok skin biopsies and clinical presentation of the disease.
Objective:
To correlate clinical diagnosis with histopathological diagnosis of leprosy patients in Nepal.
Methods:
A retrospective hospital-based study was conducted among patients with all clinical types of leprosy, classified as per the Ridley-Jopling classification. Skin biopsies were taken from active lesions in all patients and were stained with Hematoxylin and Eosin stain and modified Fite-Ferraco stain for identification of Mycobacterium leprae. The histopathological findings were compared with clinical diagnoses.
Results:
A total 156 patients were studied, out of which 84 (53.8%) males and 72 (46.1%) females between 8 and 86 years of age. The majority of patients 33 (23.57%) were in the age group of 21-30 years and least affected was children below 10 years 1(0.007%).Overall coincidence of clinical and histopathological diagnoses of classification was seen in 115 cases (80.4%). The maximum correlation (95.2%) was noted in LL patients (p value 0.000049) followed by BT(89.74%), TT (73.2%),BL(72.4%), BB(64.7%).
Conclusion:
Leprosy still continues to be one of the common infectious disease in Nepal and skin biopsy is a useful tool in confirming the clinical diagnosis of leprosy as well as for the therapeutic guide.
Insights
Histopathological examination of skin biopsies confirms clinical leprosy diagnoses in Nepal, showing high correlation across various leprosy types. This aids in accurate diagnosis and treatment guidance for this infectious disease.
Area of Science:
- Dermatology
- Infectious Diseases
- Pathology
Background:
- Leprosy, caused by Mycobacterium leprae, is a chronic infectious disease.
- The Ridley and Jopling Classification categorizes leprosy but faces interpretation variability in clinical and histopathological assessments.
Purpose of the Study:
- To correlate clinical diagnoses with histopathological findings in leprosy patients in Nepal.
- To evaluate the utility of skin biopsies in leprosy diagnosis within the Nepalese context.
Main Methods:
- A retrospective hospital-based study analyzed 156 leprosy patients classified by the Ridley-Jopling system.
- Skin biopsies were stained using Hematoxylin and Eosin and modified Fite-Ferraco stains.
- Histopathological results were compared against initial clinical diagnoses.
Main Results:
- An overall diagnostic correlation of 80.4% was observed between clinical and histopathological assessments.
- High concordance rates were found in specific leprosy types: LL (95.2%), BT (89.74%), TT (73.2%), BL (72.4%), and BB (64.7%).
- The study included patients aged 8 to 86, with the highest prevalence in the 21-30 age group.
Conclusions:
- Leprosy remains a significant infectious disease in Nepal.
- Skin biopsy is a valuable tool for confirming clinical leprosy diagnoses.
- Histopathological examination provides crucial guidance for leprosy treatment strategies.
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