Clinico-pathological study of 12 cases of patients with leprosy admitted to Sina Hospital, Hamadan, Iran, from 1991 to 2000.

BACKGROUND: Leprosy is considered a chronic disabling condition. Many clinical and immunological aspects of the disease remain ill defined.

AIM: The study of clinico-pathological and laboratory findings of patients with leprosy admitted to Sina Hospital, Hamadan, Iran, from 1991 to 2000.

METHODS AND PATIENTS: This is a descriptive retrospective cross-sectional study. The statistical community comprised all patients diagnosed leprosy. This diagnosis was clinical and confirmed through pathology (skin-biopsy) and laboratory (peripheral smear) measures.

RESULTS: In this study, the disease was more common in males than females with a mean age of 48.5 +/- 16.2 years. Most of the patients were more than 40 years old. Among 12 patients in this study, six cases were urban and six cases were rural. Six cases were living in Hamadan province and two cases migrated to Hamadan province (one of them from Afghanistan and the other from Kurdestan). Clinical diagnosis was confirmed by pathology in 11 cases, but in one case the clinical diagnosis did not match the pathology. In four cases the clinical diagnosis did not match the peripheral smear. Eight cases were admitted just once. Four cases had a history of recurrence and readmission (two patients had one time recurrence and the other two patients had two recurrences). There was no difference in the clinical findings between first presentation and recurrence. From the point of complication and disability, extremity disability was more common than eye disability. Increased severity of complications was found in patients with a delayed diagnosis and incomplete treatment.

CONCLUSION: This study showed that a rapid and correct diagnosis and complete treatment was necessary for prevention of complication and disability in patients with leprosy. Also the accuracy of pathology (skin biopsy) in the diagnosis exceeded the peripheral smear. Skin biopsy is recommended to confirm the diagnosis in all cases of leprosy. In the absence of pathology, patients must be considered as multibacillary patients and treated as such.