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Histomorphological study of leprosy

Context: Leprosy still continues to be an important public health problem. Aims: The present study was undertaken to study the histopathological features of leprosy in skin biopsies and to categorize them into various types based on microscopy, bacterial index of granuloma and to correlate with clinical presentations whenever possible. Materials and Methods: Skin biopsies after adequate fixation in 10% of formalin, were routinely processed and paraffin embedded sections of 5 μ thickness were stained with H and E and fite -faraco stain and were studied microscopically. Results: A total of 200 skin biopsies were obtained from patients with an age range of 7 -85 years, majority were in 3 rd decade, with male to female ratio of 2.6:1. Borderline tuberculoid was the most common type of leprosy (72.5%). Most common clinical feature was loss of sensation. Atrophic epidermis and grenz zone was more common in lepromatous leprosy and borderline leprosy. There were 6 biopsies with lepra reaction, 4 (66.6%) were of type 1 and 2 (33.3%) were of type 2 reactions. Majority of biopsies were of paucibacillary type (77%) and rest (23%) were of multibacillary type, clinicopathological correlation was observed in 150 biopsies (75%). Conclusions: For accurate diagnosis, correlation of clinical and histopathological features along with bacterial index appears to be more useful than considering any of the single parameters alone.