Correlation of clinical and histopathological classification of leprosy in post elimination era

Clinical and histopathological correlative study was carried out in 171 cases of leprosy using the criteria laid down by Ridley and Jopling. There was male preponderance in the study with majority of patients (35.7%) in the age goup of 21-30 years. The overall concordance between the clinical and histopathological diagnosis was 57.3%. Maximum concordance was seen in the polar ends of the spectrum with 76.9% in LL and 75.0% in TT. The concordance rate was lower in the borderline groups with 57.3% in BT, 40.0% in BL and least concordance of 16.7% in BB. However the concordance for IL was higher than the borderline groups with 66.7%. Cases in borderline group are in continuously changing immunological spectrum. Histological classification because of its definitive features gives a better indication than clinical classification for any recent shift of a case in the spectrum. Therefore skin biopsy should be done in all cases for correct classification of leprosy.