Correlation of skin and nerve histopathology in leprosy

Discrepancies have been noted in the histopathological findings between skin and nerve lesions of leprosy patients in some recent works. We studied concurrent skin and nerve biopsies in 27 randomly selected leprosy patients to correlate the histopathological features of skin and nerve lesions, and to assess the importance of neural histology in the classification of leprosy. Skin and nerve biopsies were diagnostic of leprosy in 23 and 26 patients, respectively. A discrepancy was found between the two in 15 cases. Neural histology was helpful in the classification of determinate forms in 24 cases while dermal histology was significant only in 16 patients. A multibacillary nerve and paucibacillary skin picture was observed in 3 patients. It was concluded that nerve biopsy is more informative and specific than skin biopsy in the diagnosis of leprosy and further helps to classify the patients when the skin histology is indeterminate or nonspecific.