Dermatoscopy and Clinicopathological Correlation in Different Spectrum of Leprosy

Abstract

Background: Leprosy is a chronic granulomatous infection with varied clinical presentations. Dermatoscopy is a noninvasive technique that allows rapid and magnified in vivo observation of the skin with the visualization of morphologic features that are invisible to the naked eye. In our study, we aim to describe the dermatoscopic features of all types of leprosy and correlate with clinical and histopathological findings. Materials and Methods: A prospective observational study was done on all the leprosy patients attending OPD over a period of 1 year. The study patients were categorized as per Ridley–Jopling classification. The lesions of different types of leprosy were photographed and evaluated by dermatoscopy and biopsied. Results: A total of 60 patients (34 males and 26 females) were taken under the study. Of 60 patients, 6 cases of tuberculoid leprosy, 22 cases of borderline tuberculoid (3 with Type 1 reaction), 16 cases of borderline lepromatous, 12 cases of lepromatous leprosy (5 with Type 2 reaction), and 4 cases of Histoid leprosy. The dermatoscopic features seen are yellowish-orange areas and vascular structures such as linear branching vessels and crown vessels. Broken pigment network and white chrysalis like areas are also seen. Absence or diminished hair follicles and eccrine duct openings are seen in tuberculoid spectrum. Scaling and follicular plugs are seen in type 1 reaction. Conclusion: Yellowish-orange areas and vascular structures are the common dermatoscopic features seen in leprosy. Broken pigment network and paucity of appendageal structures are other features seen.