A study of Clinico-histopathological correlation of leprosy in a tertiary care hospital in western district of Rajasthan
Author(s): Ankur Kumar, S. R. Negi, Kusum Vaishnav
Background: The clinical manifestations of leprosy are so varied and divers and can mimic variety of unrelated diseases, so for the correct and adequate treatment, the diagnosis must be made early and it should be accurate, therefore clinic-pathological correlation is extremely important in patient care.
Aims: To categorize Leprosy into various types based on microscopy and to correlate with clinical presentations.
Materials and Methods: The data base of Department of Pathology, Dr. S. N. Medical College, Jodhpur was reviewed and total 423 clinically diagnosed leprosy patients of all age groups were included in the study.
Results: A total 423 clinically diagnosed leprosy cases evaluated histopathologically. On clinical diagnosis most 74(17.5%) of the cases belonged to Borderline Borderline (BB) leprosy similarly, On histopathological study Borderline borderline (BB) subtype of leprosy was found most 106 (25.06%) common among all subtypes of leprosy and overall Clinico-histopathological agreement was seen in 266 (62.9%) cases and disagreement in 157(37.1%) cases.
Conclusion: The discordance between clinical and histopathological diagnosis was noticed because the clinical diagnosis was made on the basis of Ridley-Jopling classification, even when a histopathological examination had not been made. So instead of using single criterion to diagnose leprosy, the researcher have to consider other contributory factors such as involvement of nerve, skin adnexae, epidermal atrophy, Grenz zone, erosion of the epidermis, granuloma (epithelioid/macrophage) and bacteriological index to arrive at a definitive diagnosis of leprosy.