Objectives: The aims of the study were (1) to document the demography and clinical profile of patients with leprosy at a tertiary referral center from 2009 to 2018. (2) To compare the disease manifestation in children aged 12 years/below and the same in patients above 12 years. Materials and Methods: Case records of all patients diagnosed to have leprosy as per the World Health Organization cardinal criteria at our tertiary referral center from 2009 to 2018 were included in this study. The findings recorded in those aged 12 years/below were compared with those above 12 years using Pearson’s Chi- square test. Results: A total of 705 patients who attended our institution during the 10 year period were diagnosed to have leprosy. Six hundred and sixty-four (94.2%) were above 12 years of age and 41 patients (5.8%) were aged 12 years or below. Lepromatous spectrum cases, pure neuritic cases, Grade 2 disability, and lepra reactions were not documented in any of the patients aged 12 years or below which were contrary to the observations in those above 12 years. The differences were found to be statistically significant. Limitations: Retrospective design and small number of childhood cases were the main limitations of the study. Conclusion: Clinical presentation of leprosy in children differs from that in adults. Detection of disease in childhood offers an opportunity to cure the disease with less risk of developing some of the important disease and therapy-related complications.

Background: Cardinal criteria proposed by the World Health Organisation (WHO) lack sensitivity to diagnose indeterminate leprosy. Aims: To estimate the frequency of hypopigmented skin lesions with doubtful/minimal sensory impairment showing histopathology features of indeterminate leprosy. To compare between the histopathology findings noted in specimens showing features suggestive of indeterminate leprosy and those showing a non-specific dermatitis pattern. Materials and Methods: Data on patients who attended our department with hypopigmented patches with doubtful/minimal sensory impairment from January 2018 to December 2019 and who underwent a skin biopsy were collected. A pathologist blinded to the clinical findings reviewed the histopathology specimens using a pre-set questionnaire. Results: We studied sixteen biopsy specimens from 14 patients. Eight specimens (50%) showed histopathology suggestive of indeterminate leprosy and the remaining eight showed a non-specific dermatitis pattern. A higher percentage of patients with indeterminate pattern showed mast cells (87.5% vs 25%) and fibrosis around nerve twig or sweat duct (75% vs 12.5%) when compared to those who showed a non-specific dermatitis pattern. Limitations: Small sample size and retrospective study design were the limitations. Conclusions: We found histopathology features of indeterminate leprosy in 50% of the skin biopsy specimens from hypopigmented lesions with doubtful/minimal sensory impairment. The present study highlights the need to improve the diagnostic definition of indeterminate leprosy.