Clinical and Histopathological correlation in Hansen’s disease

AIM OF THE STUDY: To assess, classify and adopt apt treatment protocols based on histopathological evalaution of leprosy (Hansen’s) patients. MATERIALS AND METHODS: The study was conducted on the skin biopsies of 35 patients newly registered at the Department of Dermatology, Venerology & Leprosy and subsequently reported at the histopathology section of the Department of Pathology, Coimbatore Medical College & Hospital, Coimbatore for a period of 18 months from May 2010 to October 2011. Skin biopsies of newly diagnosed, untreated leprosy patients were fixed in 10% formalin and routine histopathological examination done followed by special stain (Fite – Faraco) to evaluate the bacterial index (BI). OBSERVATION AND RESULTS: From the study it was observed that, the commonest age group affected by leprosy was 31 - 50 years, males are 2 times more commonly affected than females. (M : F = 1.9 :1) & the most commonest clinically diagnosed spectrum was tuberculoid leprosy (TT). The commonest histopathologically diagnosed spectrum was IL (34.28%), followed by TT & histoid leprosy. It was observed that there was complete agreement between clinical diagnosis and histopathological diagnosis in 62.85% cases and disagreement was observed in 37.15% cases. CONCLUSION: If there is discrepancy between clinical and histopathological classification, both the findings should be reviewed by independent experienced observers. In case of confirmed discrepancy, the more advanced findings (ie. towards the lepromatous pole) should be given greater weightage and the case is to be classified and treated accordingly. In all cases of leprosy, in order to type the exact spectrum of disease for appropriate treatment, skin biopsy of the lesions with histopathological examination followed by special stain (Fite -Faraco) is recommended