Finding Correlation in Clinical and Pathological Diagnosis in Reemerging Context of Leprosy in India: A Tertiary Care Center Experience

  • Ajeet Kumar Prajapati Department of Pathology JNMC AMU Aligarh
  • Ruquiya Afrose Department of Pathology JNMC AMU Aligarh
  • Geeta Maurya Department of Pathology UPUMS Saifai Etawah
  • Nazoora Khan Department of Pathology JNMC AMU Aligarh
  • Kiran Alam Department of Pathology JNMC AMU Aligarh
Keywords: Correlation study, Leprosy, Reemerging context


Background: Leprosy was supposed to be eliminated by WHO from the world by the end of the year 2000. However, it still affects the major population in India. It is well realized that even after elimination target has been achieved, new leprosy cases will keep coming for at least some years due to continuation of some level of disease transmission or manifestation of disease by subclinical cases. Hence there is the need to review this disease with proper understanding. Objective: To determine the current leprosy profile and its relation between clinical and pathological diagnosis, at our centre catering the population of Western Uttar Pradesh. Methods and Material:     It’s a retrospective study and was carried out on skin biopsy samples sent for histopathological diagnosis in clinical suspicion of leprosy at Jawaharlal Nehru Medical College and Hospital, Aligarh, from June 2015 to November 2017. Tissue Sections were stained with Haematoxylin and Eosin stain for morphological studies, and modified fite stain to identify acid fast bacilli. Results: Out of 325 clinically suspected leprosy cases, we diagnosed leprosy in 282 cases with 86.7% parity. Most commonly affected age group was between 16 -30 years (110 cases). Tuberculoid leprosy was the most common histological subtype (69/282, 24.4%) followed by lepromatous leprosy (58/282, 20.56%), borderline tuberculoid (53/282, 18.7%), borderline lepromatous (42/282, 14.8%), indeterminate leprosy (34/282, 12%) and mid borderline leprosy (22/282, 7.8%). Additionally, histioid type of leprosy was diagnosed histologically in 1.4% (4/282) of the cases. Conclusions: Identification of suspicious skin patch as leprosy with prompt histological diagnosis especially in population of below 30 years is required for timely intervention and eradication. Both clinician and pathologist should have a focused approach especially in diagnosing indeterminate leprosy.


Shepard CC. The nasal excretion of Mycobacterium leprae in leprosy. Int J Lepr. 1962;30:10-8.

Job CK. Nasal mucosa and abraded skin are the two routes of entry of Mycobacterium leprae. Star. 1990;49:1.

Ploemacher T, Faber WR, Menke H, Rutten V, Pieters T. Reservoirs and transmission routes of leprosy; A systematic review. PLoS Negl Trop Dis. 2020 Apr 27;14(4):e0008276.

Hatta M, van Beers SM, Madjid B, Djumadi A, de Wit MY, Klatser PR. Distribution and persistence of Mycobacterium leprae nasal carriage among a population in which leprosy is endemic in Indonesia. Trans R Soc Trop Med Hyg. 1995;89:381-5.

Cree IA, Smith WC. Leprosy transmission and mucosal immunity: towards eradication? Lepr Rev. 1998;69:112-21.

Ridley DS, Jopling WH. A classification of leprosy for research purposes. Lepr Rev. 1962;33:119-28.

Meneses S, Cirelli NM, Aranzazu N, Rondon Lugo AJ. Lepra visceral: presentacion de dos casos y revision de la literatura. Dermatol Venez. 1988;26:79-84.

Chemotherapy of leprosy for control programmes: report of a WHO study group. Technical Report Series, 675. WHO: Geneva; 1982.

Ploemacher T, Faber WR, Menke H, Rutten V, Pieters T. Reservoirs and transmission routes of leprosy; A systematic review. PLoS Negl Trop Dis. 2020;14:1–27.

World Health Organization. Weekly epidemiological record. Global leprosy update, 2019. 2020; Available from:

World Health Assembly. Forty-fourth World Health Assembly, Geneva, 6-16 May 1991: resolutions and decisions, annexes. Geneva: World Health Organization; 1991.

National health portal India on world leprosy day 30th jan 2021

Special Correspondent, India achieves leprosy eradication target. The Hindu News paper. 2006. Jan 31, p. 15. Available from: col 1

Mehta B, Nayak C, Savant S, Amladi S. Leprosy in the era of integration. Indian J Dermatol Venereol Leprol. 2009;75:190–1.

Census of India 2001. [Last accessed on 2012 Nov 21]. Available from

Sachdeva S, Sood AK. Leprosy Elimination Monitoring (LEM) in India: a novel exercise of monitoring, learning, and capacity building. Indian J Community Med 2014; 39 : 59-62.

Pandey A. Role of dermatologist in leprosy elimination and post-elimination era. Lepr Rev 2007; 78 : 26-9.

Kaur T, Kaur J, Malhotra SK, Kalra RK. Leprosy in northern india during post elimination era (2005-2015): a retrospective data analysis. Indian journal of applied research. 2018;7.

Singh sk, Singh mk. Mdt therapy in paucibacillary leprosy: a clinicopathological assessment. Paripex-indian journal of research. 2018;6.

Viswanathan k. Histopathological and clinical study of leprosy cases in semi urban and rural india. Paripex-indian journal of research.2018;7.

Gokhale CN, Borgaonkar CA, Solanki MJ, Shanbhag SS. Trend analysis of leprosy cases at a primary health centre in thane district of maharashtra. Global journal for research analysis 2018;7.

Li Y-Y, Shakya S, Long H, Shen L-F and Kuang Y-Q (2021) Factors Influencing Leprosy Incidence: A Comprehensive Analysis of Observations in Wenshan of China, Nepal, and Other Global Epidemic Areas. Front. Public Health 9:666307.

Shrestha A, Chauhan S, Mathur M. Clinicohistopathological correlation of leprosy. Journal of Pathology of Nepal. 2017;7:1095-1102.

Kini RG, Choudhury H. Clinicopathological correlation in diagnosis of Hansen’s disease: A histopathologist’s perspective. Journal of Interdisciplinary Histopathology. 2017;5:48-54.

Semwal S, Joshi D, Goel G, Asati D, Kapoor N. Clinico-histological correlation in Hansen's disease: Three-year experience at a newly established tertiary care center in central India. Indian J Dermatol. 2018;63:465-468.

Mathur MC, Ghimire RB, Shrestha P, Kedia SK. Clinicohistopathologiacl correlation in leprosy. Kathmandu Univ Med J. 2011;9:248-451. PMID: 22710532.

Moorthy BN, Kumar P, Chatura KR, Chandrasekhar HR, Basavaraja PK. Histopathological correlation of skin biopsies in leprosy. Indian J Dermatol Venereol Leprol. 2001;67:299-301.

28.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;61:433-8.

Nadkarni NS, Rege VL. Significance of histopathological classification in leprosy. Indian J Lepr.1999;71:325-332.

Kar PK, Arora PN, Ramasastry CV, Sayal SK, Dhaka RS. A clinicopathological study of macular lesions in leprosy Indian J Lepr.1994;66:435-442.

Kalla G, Salodkar A, Kachhawa D. Clinical and histopathological correlation in leprosy. Int J Lepr Other Mycobact Dis. 2000;68:184- 185.

Original Article