Spectrum of Clinical and Demographic features of Histopathologically proven Hansen’s disease cases- study in a Tertiary care centre
Introduction: Leprosy or Hansen disease is a slowly progressive infection caused by Mycobacterium leprae that mainly involves skin, peripheral nervous system, upper respiratory tract, eyes and testes. Leprosy is one of the oldest debilitating diseases, still there are no tools to diagnose subclinical infections and to culture the bacteria. Analysis of epidemiological data, clinical features and histopathological features and their interpretation plays a very crucial role in early diagnosis, treatment, disability prevention and most importantly elimination of social stigma in society pertaining to disease. Adequate clinical information combined with histopathology and bacteriological index help in diagnosis and classification of different types of leprosy there by in management of cases.
Objectives: 1. To study the age and sex distribution among cases with Hansen’s disease. 2. To study the Spectrum of Clinical and Demographic features of Histopathologically proven Hansen’s disease cases and classify according to Ridley-Jopling classification.
Methods: In the present study, the skin biopsies of cases clinically diagnosed or suspected of Hansen’s disease submitted to the Department of Pathology, Karnataka Institute of Medical sciences, Hubballi, over a period of 3 years (1 year retrospective and 2years prospective study) between July 2019 to June 2022, were studied. Paraffin blocks are prepared followed by staining the 5-micron thickness sections with haematoxylin and eosin with standard techniques as observed in Department of Pathology, KIMS, Hubballi. Various clinical and histopathological spectrum of skin lesions in Hansen’s disease were studied and classified according to Ridley-Jopling classification.
Results: Majority of the patients, that is 72 (25.4%) cases were in age interval of 31-40 years. Least incidence of leprosy cases was observed in the age group of 71- 80 years accounting to 5 (1.8%) cases. Male to female ratio of 1.9:1. Borderline Tuberculoid Leprosy (BT) was the most common type of leprosy, accounting to 130 (45.7%) cases which was followed by Indeterminate Leprosy (IL) in 42 (14.8%) cases.
Conclusions: This study concludes that correlation of clinical features, histopathological findings and bacterial index is very essential for arriving at diagnosis and proper typing of leprosy, which in turn prevents disability and drug resistance.