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Histopathological Study of Leprosy Patients in a Tertiary Care Hospital in Navi Mumbai

Abstract

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.

More information

Type
Journal Article
Author
Roy P
Dhar R
Patro P
M B H
Sahu S