Correlation Between Clinical And Histopathological Criteria For The Classification Of Leprosy

Clinicians and histopathologists sometimes disagree on the classification of a case of leprosy. A detailed histopathological study of 92 fresh uncomplicated cases representing the whole spectrum of leprosy was done for the last one year. There was complete agreement between clinical and histopathological diagnosis in 53 cases (57.61)% and disparity in 39 cases (42.39%). Among the latter, shift towards the lepromatous pole of the spectrum was found in 13 cases (14.13%) and shift towards tuberculoid pole in 26 cases (28.26%). The latter group included 16 cases (17.39%) where histopathological diagnosis was indeterminate leprosy because of the presence of early histopathological changes. It is concluded that in case of discrepancy, the more advanced finding (i.e. towards the lepromatous pole) should be given greater weightage and the case is to be classified and treated accordingly.