Histoid leprosy: Role of fine needle aspiration cytology in the diagnosis

Histoid leprosy is a distinct variant of lepromatous leprosy. It presents clinically as well demarcated cutaneous and subcutaneous nodules similar to dermatofibroma. A 40 year old male, presented with multiple progressive skin lesions on buttock, trunk, face, back and extremities of six months duration. Examination findings revealed multiple, irregular, bilateral, symmetrical shiny cutaneous nodules over the above mentioned sites. Radial, ulnar, radial cutaneous and lateral popliteal nerve thickening was seen. Fine needle aspiration cytology (FNAC) showed features of histoid leprosy, which was confirmed by histopathology. Modified Ziehl-Neelsen stain for Acid fast bacilli was positive. Bacterial index was 6+. Histoid leprosy is an unusual variant of lepromatous leprosy. The identification of histoid leprosy and differentiation of it from lepromatous leprosy helps to facilitate the follow up of patients with regards to the drug sensitivity, relapse and reaction. We present here the role of FNAC in the diagnosis of histoid leprosy