Clinicopathological correlation of Hansen's disease: a retrospective study of skin biopsies

Abstract

Background: Hansen’s disease is a curable chronic infectious disease. The clinical presentation and histopathological interpretation of skin biopsy may show variations as various types of the disease exist. The clinical diagnosis should be confirmed by histopathological features and bacteriological study before starting treatment for particular type of the disease. Materials and Methods: A retrospective hospital based study was conducted among patients with clinically diagnosed Hansen’s disease classified according to Ridley-Jopling scale. Skin biopsy taken from active lesion was stained with routine Haematoxylin & Eosin (H & E) stain and modified Fite-Faraco’s stain for acid-fast bacillus. Results: Out of 107 histologically confirmed cases, male to female ratio was 1.6:1. The age of the patients ranged from 4-80years. Clinically, BT was the most common type of leprosy with 43% cases followed by TT 20.64% cases, LL 14.95%, BL 13%, IL 8.41% and least common type of leprosy seen clinically was BB with 0% cases. The commonest type on histopathology was BT with 39.25% followed by TT 19.62%. The correlation was highest in lepromatous leprosy(100%).The Clinical and histopathological correlation was seen in 85 cases (79.44%). Conclusion: There can be overlap between different types of leprosy, both clinically and morphologically. So correlation of clinical and histopathological features along with bacteriological index appears to be more useful for accurate typing of leprosy. The concordance was high in LL. BB is rarely diagnosed both clinically and histopathologically. Keywords: Leprosy, Acid-fast bacilli, Granuloma, Foamy macrophage