Significance of Histopathology in Leprosy Patients with 1–5 Skin Lesions with Relevance to Therapy

Abstract

Background:Patients with 1–5 skin lesions are clinically categorized as paucibacillary for treatment purposes. For betterment and adequate treatment of patients, this grouping needs further study.Aim:To study a group of leprosy patients with 1–5 skin lesions, compare clinical details with histopathological findings and bacteriological status of the skin to evaluate the relevance of this grouping.Materials and Methods:Two-year study involving 31 patients of leprosy with 1-5 skin lesions was included in this study. A number of skin lesions were recorded. Skin biopsies were taken in all patients. The biopsies were evaluated for the type of pathology and acid fast bacilli (AFB) status.Results:Of 31 patients, 19 (61.2%) had single skin lesion, 7 (22.5%) had two lesions, 4 (12.9%) had three lesions, and only one (3.22%) had four lesions, there were no patients with five lesions. Of the 31 patients, 30 (96.7%) were clinically diagnosed as borderline tuberculoid and one patient (3.22%) has tuberculoid leprosy. Skin smears were negative for AFB in all patients. The histological diagnoses were: TT 1 (3.22%), BT 24 (77.41%), and IL 6 (19.2%). AFB were found in 2 (6.45%) out of 31 skin biopsies. Clinicopathological correlation was 76.6% in the BT group.Conclusion:Tissue biopsy findings in 1–5 skin lesions which were not considered relevant for treatment purposes until now should be given a status in the categorization and assessment of severity of the disease. The significance of finding of AFB and histopathology of multibacillary (MB) type of leprosy in tissue biopsies, in patients grouped as PB should be resolved so that patients could be given the drug therapy and duration of therapy they warrant.

Polymerase Chain Reaction (PCR) as a Potential Point of Care Laboratory Test for Leprosy Diagnosis—A Systematic Review

“…Hence it is imperative to widen the scope and accuracy of leprosy detection for early identification before the consequences of nerve damage have set in [9]. The current standard diagnosis of leprosy is mostly based on clinical evaluation of patients, except in a few settings where the microscopy of slit skin smears (SSS) for acid-fast bacilli and/or histopathological examination (HPE) of skin biopsies are being used as additional tests [10]. Clinical manifestations of leprosy are determined by patient immune responses to Mycobacterium leprae .…”