Background & Aims: Hansen’s disease, Leprosy, is a chronic granulomatous infectious disease caused by Mycobacterium leprae, principally affecting the skin and peripheral nerves. Histopathological examination plays an important role in early diagnosis and management. The aim of this study was to study the correlation of histomorphological findings with the bacteriological index in different types of leprosy, and to inspect the histopathological spectrum of leprosy.
Materials & Methods: The retrospective study was carried out on the skin punch biopsies from 121 cases of leprosy taken in the Department of Dermatology at a tertiary care center and reported in the histopathology section of the Department of Pathology between January 2022 to December 2022. Hematoxylin-Eosin and Fite-Faraco-Stained sections were evaluated for features confirming leprosy and further categorized as per Ridley-Jopling system.
Results: Among total 121 skin biopsies examined histopathologically, the most common type seen was Borderline Tuberculoid (BT) Leprosy (32.23%), followed by Lepromatous Leprosy (LL) (20.66%), Borderline Lepromatous (BL) Leprosy (16.52%), Histoid Leprosy (HL) (12.39%), Tuberculoid Leprosy (TL) (9.91%), Erythema Nodosum Leprosum (ENL) (6.61%), and Neuritic (NL) and mid borderline leprosy diagnosed each 1 case (0.82%). Fite-Faraco staining to identify acid-fast bacilli (AFB) was done in all 121 cases, which was positive in 64 (52.8%) of the cases. No bacilli were noted in all cases of TT leprosy, whereas all cases of Histoid types showed the presence of acid-fast bacilli. The correlation of histopathological diagnosis and bacteriological index was seen in 52.8% of the cases. The highest correlation was seen in Histoid Hansen’s disease (100%), LL (80%), ENL (75%), BL (70%) followed by BT (23%), TT (0%), Neuritic Leprosy (0%), and BB (0%).
Conclusion: The correlation between clinical manifestations, histopathological, and bacteriological features were required for diagnosis and classification of leprosy. Nerve damage is irreversible, therefore, early detection and treatment is important to prevent disabilities.