02016nas a2200133   4500000000100000008004100001100001400042700001300056245012000069856008000189300001200269490000700281520159400288       2021                            d1 aChadha AA1 aDongre A00aA Single Centre Cross-Sectional Study of Clinicopathological Correlation in Leprosy: Discordance and Spectral Shift  uhttps://www.ijl.org.in/2021-apr-jun/3-AA%20Chadha%20et%20al%20(143-156).pdf  a143-1560 v933 aClassifying a case of Leprosy is very important from the point of view of management, prognosis and
complications. Among the various methods, the Ridley-Jopling (R-J) classification is most widely used.
However, there are discrepancies between the clinical diagnosis and histopathological diagnosis across the
spectrum, necessitating correlation for accurate diagnosis and management. This study aimed to correlate
the clinical and histopathological diagnosis of Hansen's disease and study its effect on the classification.
Seventy-nine non-reactional cases of leprosy were subjected to clinical and histopathological examination
and classified separately according to R&J classification and WHO classification. On confirmation, the
diagnoses were correlated, concordance and discordance noted and analysed. A perfect correlation was
found in total of 48.1% patients, maximum in TT (66.7%) followed by BL (65%). Major mismatch was seen in
31.7% of cases. A statistically significant correlation of the Fite Faraco positivity for Acid-fast bacilli was found
with the histopathological diagnosis than with the clinical. The higher 51.9% discordance in the clinical and
histopathological classification points towards the possibility of a spectral shift having occurred in the Indian
population (from paucibacillary to multibacillary), which may be responsible for the resurgence of cases and
pushing us back in time with regards to the elimination of Leprosy and failure of the existing control programs.
Hence clinicopathological correlation should be mandatory in every case.