Significance of histopathology in the evaluation of paucibacillary leprosy

Background: Leprosy patients are classified into paucibacillary and multibacillary types on the basis of the number of skin lesions for the purpose of therapy. Patients with 1–5 skin lesions are clinically categorized as paucibacillary for treatment purposes. Aim: To study paucibacillary leprosy cases and compare clinical details with histopathological findings. Materials and methods: Three and half year study involving 130 patients of paucibacillary cases of leprosy diagnosed clinically and based on the 1–5 skin lesions was included in this study after ethical clearance and taking informed consent from patients. A number of skin lesions were recorded. Skin biopsies were taken in all patients. Biopsies were evaluated for the type of pathology and acid fast bacilli (AFB) status. Results: Of 130 patients, 81(62.3%) were males and 49(37.6%) were females. Majority of the clinically classified cases were borderline tuberculoid leprosy. The histological diagnoses were: TT 19(14.6%), BT 40(30.7%), IL 51(39.2%) and No evidence of leprosy 20(15.3%). AFB were found in 3(15.3%) out of 130 skin biopsies and all were borderline tuberculoid leprosy. Conclusion: Tissue diagnosis play a significant role in the diagnosis of leprosy. Early and borderline cases of leprosy poses a diagnostic difficulty to label only on clinical basis, so histopathological evaluation is must for confirming the diagnosis in doubtful cases of leprosy.