Finding Correlation in Clinical and Pathological Diagnosis in Reemerging Context of Leprosy in India: A Tertiary Care Center Experience

Abstract

Background:
 Leprosy was supposed to be eliminated by WHO from the world by the end of the year 2000. However, it still affects the major population in India. It is well realized that even after elimination target has been achieved, new leprosy cases will keep coming for at least some years due to continuation of some level of disease transmission or manifestation of disease by subclinical cases. Hence there is the need to review this disease with proper understanding.
 Objective:
 To determine the current leprosy profile and its relation between clinical and pathological diagnosis, at our centre catering the population of Western Uttar Pradesh.
 Methods and Material: 
 It’s a retrospective study and was carried out on skin biopsy samples sent for histopathological diagnosis in clinical suspicion of leprosy at Jawaharlal Nehru Medical College and Hospital, Aligarh, from June 2015 to November 2017. Tissue Sections were stained with Haematoxylin and Eosin stain for morphological studies, and modified fite stain to identify acid fast bacilli.
 Results:
 Out of 325 clinically suspected leprosy cases, we diagnosed leprosy in 282 cases with 86.7% parity. Most commonly affected age group was between 16 -30 years (110 cases). Tuberculoid leprosy was the most common histological subtype (69/282, 24.4%) followed by lepromatous leprosy (58/282, 20.56%), borderline tuberculoid (53/282, 18.7%), borderline lepromatous (42/282, 14.8%), indeterminate leprosy (34/282, 12%) and mid borderline leprosy (22/282, 7.8%). Additionally, histioid type of leprosy was diagnosed histologically in 1.4% (4/282) of the cases.
 Conclusions:
 Identification of suspicious skin patch as leprosy with prompt histological diagnosis especially in population of below 30 years is required for timely intervention and eradication. Both clinician and pathologist should have a focused approach especially in diagnosing indeterminate leprosy.