Histomorphological Study of Leprosy with Clinical Correlation in Kumaon Region

Abstract

Background: Leprosy is a leading cause of permanent physical disability. Approx 60% of global burden of leprosy is represented by India. Histopathological examination is still considered gold standard for accurate categorization of leprosy so that timely treatment can be started.

Objectives:  To categorize and correlate types of leprosy clinically and histomorphologically in Kumaon region.

Methods: The present cross-sectional study of 62 cases was conducted in the Department of Pathology & Skin and V.D in a tertiary care centre of Kumaon region from August 2016 to April 2018. The cases were clinically examined and categorized according to Ridley-Jopling classification. Skin Biopsy and Slit-Skin Smear (SSS) were taken for accurate histomorphogical categorization of leprosy and assessment of bacterial index, followed by clinico-histomorphological correlation. Statistical analysis was done in term of chi-square test. Kappa test was used as agreement test for clinical versus histological classification of different type of leprosy.

Results:  A total of 62 clinically diagnosed leprosy cases evaluated histopathologically. Clinically, lepromatous leprosy (LL) was the most common type of leprosy (38.70%), followed by borderline tuberculoid (30.64%). On histopathological examination, indeterminate leprosy (IL) (21 cases; 33.90%) was the most common followed by lepromatous leprosy (16 cases; 25.80%).  Overall clinico-histopathological correlation was seen in 36 cases (58. 06%) with maximum correlation seen in indeterminate leprosy (100%) and tuberculoid leprosy (TT) (100%). Conclusion: This study concludes that correlation of clinical and histopathological features along with bacterial index is more useful for accurate typing of leprosy than considering any of the single parameter alone so that early and appropriate treatment could be started.