Clinical and histological profile of leprosy patients at rural based tertiary care centre in post elimination era
Keywords:
Bacillus, Biopsy, Granulomatous Disease, Leprosy, Mycobacterium leprae, Skin
Abstract
Background: Despite India having achieved the national leprosy elimination goal of prevalence rate less than one case per 10000, the disease is still prevalent. Its diverse presentation depending on immune status of host warrants a clinico-histological correlation for diagnosis and start of proper therapy.Aim: The present study was done with the aim to describe the spectrum of clinical and histological profile of leprosy patients especially in doubtful and difficult cases especially where the clinical diagnosis is not sufficient and, then, to correlate clinical and histological profile.Methods: This study is a hospital based prospective study conducted on sixty newly diagnosed cases of leprosy. Skin biopsy was taken in each case and processed routinely. All the cases were stained with hematoxylin and eosin and modified Ziehl-Neelsen stain. Ridley-Jopling classification was used for diagnosis and typing of cases.Results: In the present study consisting of 60 newly diagnosed leprosy patients, majority of the cases i.e. 18 (30%) were in age group of 21-30 years with male: female ratio of 1.6:1. The most common type of skin lesion was plaque (50%), followed by hypo-pigmented macule (33.3%). The clinico-pathological concordance was maximum in Tuberculoid (TT) (100%) followed by Lepromatous (LL) (80%), Borderline lepromatous (BL) (72.7%), Borderline tuberculoid (BT) (50%) and Mid-borderline (BB) (33.3%).Conclusion: The overall clinicopathological concordance in present study is good (66.7%). Thus, the correlation of clinical and histological features along with bacillary index is far more useful for accurate typing and therapy in leprosy patients.DOI:10.21276/APALM.1680References
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11. Moorthy BN, Kumar P, Chatura KR, Chandrasekhar HR, Basavaraja PK. Histopathological correlation of skin biopsies in leprosy. Indian J Dermatol Venereol Leprol 2001;67(6):299.
12. Mathur MC, Ghimire RBK, Shrestha P, Kedia SK. Clinicohistopathological Correlation in Leprosy. Kathmandu Univ Med J 2011;9(4):248–51.
13. Giridhar M, Arora G, Lajpal K, Chahal KS. Clinicohistopathological concordance in leprosy - a clinical, histopathological and bacteriological study of 100 cases. Indian J Lepr 2012;84(3):217–25.
14. Bijjaragi S, Kulkarni V, Suresh KK, Chatura KR, Kumar P. Correlation of clinical and histopathological classification of leprosy in post elimination era. Indian J Lepr 2012;84(4):271–5.
15. Kumar A, Negi SR, Vaishnav K. A study of Clinico-histopathological correlation of leprosy in a tertiary care hospital in western district of Rajasthan. J Res Med Dent Sci 2014;2(3):43.
16. Bommakanti J, Putta S, Gokhale S. Histopathological Relevance in Clinical Spectrum of Hansen’s Disease. J Med Sci Clin Res 2016;4(12):14678–84.
17. Badhan R, Kundal RK, Raj RT, Bahl RK, Bal MS. A Clinico-Pathological Correlation Study of Leprosy in a Tertiary Care Teaching Institute in Northwest Punjab, India. Am J Med Sci Med 2014;2(5):99–108.
18. Bhatia AS, Katoch K, Narayanan RB, Ramu G, Mukherjee A, Lavania RK. Clinical and histopathological correlation in the classification of leprosy. Int J Lepr Other Mycobact Dis 1993;61(3):433–8.
19. Kalla G, Salodkar A, Kachhawa D. Clinical and histopathological correlation in leprosy. Int J Lepr Other Mycobact Dis 2000;68(2):184–5.
20. Goyal S, Shah N, Shah FR, Shah NR, Shah CK, Shah JM. Clinicopathological Correlation with Histomorphological Spectrum and Bacillary Index of Skin Biopsy in Leprosy. Gujarat J Pathol Microbiol 2015;7:157.
21. Sandeep M, Murugesh S. A Study of Clinico-Pathological Concordance in Leprosy Patients in the Post-Elimination Era. Int J Sci Res 2016;5(2):1304–6.
22. Verma KC, Ganguli DD, Jain VK. Applicability of Ridley-Jopling scale in clinical practice. Lepr India 1981;53(4):556–61.
23. Jerath VP, Desai SR. Diversities in clinical and histopathological classification of leprosy. Lepr India 1982;54(1):130–4.
24. Kar PK, Arora PN, Ramasastry CV, Sayal SK, Dhaka RS. A clinico-pathological study of macular lesions in leprosy. Indian J Lepr 1994;66(4):435–42.
25. Pandya AN, Tailor HJ. Clinicohistopathological correlation of leprosy. Indian J Dermatol Venereol Leprol 2008;74(2):174.
26. Mehta B, Desai NJ, Khar S. Clinico-Pathological Co-relation in Leprosy. Internet J Dermatol 2012;9(1):4.
2. Woods GL, Myers WM. Mycobacterial Diseases. In: Anderson’s Pathology. St. Louis: Mosby; 1996. page 843–61.
3. Dharmendra, editor. Leprosy. 1st ed. Bombay: Kothari Medical Publishing House; 1978.
4. World Health Organisation. Global leprosy update, 2014: need for early case detection. Wkly Epidemiol Rec 2015;90(36):461–74.
5. Regional Office for South-East Asia. Global Leprosy Strategy 2016-2020. Accelerating towards a leprosy-free world. India: World Health Organization; 2016.
6. Expert Committee on Leprosy. Eighth report. Geneva: World Health Organization; 2012.
7. National Leprosy Eradication Programme - Progress Report for the year 2014-15. New Delhi: Central Leprosy Division, Directorate General of Health Services, Government of India; 2015.
8. Ridley DS, Jopling WH. Classification of leprosy according to immunity. A five-group system. Int J Lepr Other Mycobact Dis 1966;34(3):255–73.
9. Lucas S. Bacterial Diseases. In: Lever’s Histopathology of the Skin. Philadelphia: Lippincott Williams & Wilkins; 2009. page 558–67.
10. Ridley DS. Histological classification and the immunological spectrum of leprosy. Bull World Health Organ 1974;51(5):451–65.
11. Moorthy BN, Kumar P, Chatura KR, Chandrasekhar HR, Basavaraja PK. Histopathological correlation of skin biopsies in leprosy. Indian J Dermatol Venereol Leprol 2001;67(6):299.
12. Mathur MC, Ghimire RBK, Shrestha P, Kedia SK. Clinicohistopathological Correlation in Leprosy. Kathmandu Univ Med J 2011;9(4):248–51.
13. Giridhar M, Arora G, Lajpal K, Chahal KS. Clinicohistopathological concordance in leprosy - a clinical, histopathological and bacteriological study of 100 cases. Indian J Lepr 2012;84(3):217–25.
14. Bijjaragi S, Kulkarni V, Suresh KK, Chatura KR, Kumar P. Correlation of clinical and histopathological classification of leprosy in post elimination era. Indian J Lepr 2012;84(4):271–5.
15. Kumar A, Negi SR, Vaishnav K. A study of Clinico-histopathological correlation of leprosy in a tertiary care hospital in western district of Rajasthan. J Res Med Dent Sci 2014;2(3):43.
16. Bommakanti J, Putta S, Gokhale S. Histopathological Relevance in Clinical Spectrum of Hansen’s Disease. J Med Sci Clin Res 2016;4(12):14678–84.
17. Badhan R, Kundal RK, Raj RT, Bahl RK, Bal MS. A Clinico-Pathological Correlation Study of Leprosy in a Tertiary Care Teaching Institute in Northwest Punjab, India. Am J Med Sci Med 2014;2(5):99–108.
18. Bhatia AS, Katoch K, Narayanan RB, Ramu G, Mukherjee A, Lavania RK. Clinical and histopathological correlation in the classification of leprosy. Int J Lepr Other Mycobact Dis 1993;61(3):433–8.
19. Kalla G, Salodkar A, Kachhawa D. Clinical and histopathological correlation in leprosy. Int J Lepr Other Mycobact Dis 2000;68(2):184–5.
20. Goyal S, Shah N, Shah FR, Shah NR, Shah CK, Shah JM. Clinicopathological Correlation with Histomorphological Spectrum and Bacillary Index of Skin Biopsy in Leprosy. Gujarat J Pathol Microbiol 2015;7:157.
21. Sandeep M, Murugesh S. A Study of Clinico-Pathological Concordance in Leprosy Patients in the Post-Elimination Era. Int J Sci Res 2016;5(2):1304–6.
22. Verma KC, Ganguli DD, Jain VK. Applicability of Ridley-Jopling scale in clinical practice. Lepr India 1981;53(4):556–61.
23. Jerath VP, Desai SR. Diversities in clinical and histopathological classification of leprosy. Lepr India 1982;54(1):130–4.
24. Kar PK, Arora PN, Ramasastry CV, Sayal SK, Dhaka RS. A clinico-pathological study of macular lesions in leprosy. Indian J Lepr 1994;66(4):435–42.
25. Pandya AN, Tailor HJ. Clinicohistopathological correlation of leprosy. Indian J Dermatol Venereol Leprol 2008;74(2):174.
26. Mehta B, Desai NJ, Khar S. Clinico-Pathological Co-relation in Leprosy. Internet J Dermatol 2012;9(1):4.
Published
2018-04-28
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