Clinico-histopathological correlation of leprosy in western region of Nepal-A pioneer pilot study

Abstract

Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae disease affecting mainly cutaneous and peripheral nervous system. This entity expresses with a wide array of clinical manifestations and may mimic variety of disparate diseases, therefore is difficult to diagnose clinically, so for the adequate treatment and better prognosis, the diagnosis must be made early and it should be accurate, therefore clinic-pathological correlation is extremely important. Hence, the present study was conducted to correlate different types of leprosy clinically and histopathologically. Objectives: To analyze different histological types of leprosy, correlate histopathological diagnosis with clinical diagnosis and study the uniformity of clinical and histological findings in the diagnosis of leprosy. Methodology: This study was conducted on 21 biopsy samples received in Department of Dermatology, Nepalgunj Medical College and Teaching Hospital, Nepalgunj over a period of one year from December 1, 2014 to December 31, 2015. All the clinically diagnosed new skin lesions (clinical classifications noted) were subjected for biopsy; tissue specimen were fixed in 10% formalin and sent for histopathological analysis. 5 micron sections were stained with haematoxylin and eosin for morphological assessment and with modified Fite-Farcao stain for identification of the lepra bacilli. Ridley and Jopling classification was applied for histopathological taxonomy. Data was analyzed using SPSS software version 15.0 and kappa test was applied to evaluate the concordance results. Results: The present study comprised of 21 patients, 12 were males (57.1%) and 9 females (42.9%) with a male: female ratio of 1.33:1. Majority of the patients were between 31 to 40 years of age. Based on histopathology, 14 (66.7%) patients had Tuberculoid leprosy (TT); 5 patients had Borderline Lepromatous (BL) leprosy; 1 (4.8%) had Borderline Tuberculoid (BT) leprosy and Lepromatous Leprosy (LL) eac