Histopathological Study of Leprosy Patients in a Tertiary Care Hospital in Navi Mumbai
Background: Leprosy or Hansen’s disease is a chronic infectious disease that mainly affects skin and peripheral nerves. Histopathology and demonstration of lepra bacilli is a vital tool to supplement clinical examination and diagnosis for correct classification and therefore treatment of patients. Aim: To study histopathology of leprosy cases and identify histological types in patients in a tertiary care hospital in Navi Mumbai. Materials and Methods: 50 skin biopsies diagnosed as leprosy over a period of two years from January 2017 to December 2018 were studied. Haematoxylin-eosin and Fite-Faraco staining for demonstrating lepra bacilli were done. Results: Male to female ratio of patients was 4.5:1. Maximum number of cases was seen in the 3rd decade of life. The commonest histological type was borderline tuberculoid (18 cases, 36%), followed by tuberculoid type (8 cases, 16%); least common cases were of borderline lepromatous, indeterminate and histoid types (4 cases, 8%). The most common site was forearm (26%). All 12/50(24%) patients with affected nerves showed ulnar nerve involvement. Hypopigmented, anaesthetic plaque was the commonest clinical feature followed by erythematous lesions. All cases of histoid and lepromatous type showed acid-fast bacilli on Fite stain. Tuberculoid cases showed perineural infiltration and well-formed granulomas, borderline tuberculoid type showed additional feature of giant cells and lepromatous types showed grenz zone and no granulomas. Histoid type showed fusiform histiocytes resembling spindle cells. Conclusion: Histopathological examination is the gold standard for accurate diagnosis and typing of leprosy. It should be done in all leprosy cases presenting to the clinician.