An Evaluation of Clinical Spectrum of Leprosy in and Around a Tertiary Care Hospital in North India

Abstract

Background:-Leprosy(Hansen's disease)is a chronic infectious disease caused by Mycobacterium leprae. It is classified into 5 groups based on clinical,bacteriological,immunological and histopathological status of patients(Ridley-Jopling classification).However a great variation has been observed in the interpretation of histopathological examination of skin biopsies and clinical presentation of disease Objectives:-To correlate clinical diagnosis with histopathological diagnosis of leprosy patients in Tertiary care hospital in north India Material and Methods:-The presents study includes all the new leprosy patients visiting the OPD of skin and V.D. department, HIMS, Safedabad, Barabanki,U.P.It is a hospital based cross-sectional study conducted among patients with all clinical types of leprosy,classified as per Ridley-Jopling classification. Skin biopsies were taken from active lesion in all patients and were stained with H and E stain for identification of Mycobacterium leprae ,slit smears were done to study bacillary index.All clinicopathologically diagnosed cases of TTHD and BTHD will be subjected to S-100 stain. Results: More than one third of the patients were between 31-40 years (39.6%) followed by 20-30 (18.9%), 41-50 (17%), >50 (13.2%) and <20 (11.3%). More than half of the patients were males (11.3%). The family history of leprosy was present among 9.4% of the patients. Hypopigmented skin lesion was the most common clinical symptom (32.1%). TT was the most common clinical diagnosis (26.4%). IL was the most common histopathological diagnosis (26.4%). Atrophy epidermis changes was found in 50.9% patients. Pauci bacillary was found in 62.3% of the patients. Conclusion: Leprosy though reported to be eliminated still continues to be one of the common infectious diseases in Uttar Pradesh, India and necessitates revival of our knowledge regarding the disease. Skin biopsies, slit smears and IHC S-100 are useful tools in confirming the clinical diagnosis of leprosy as well as for the therapeutic guide.