Introduction: Hansens disease is a chronic infectious disease caused by Mycobacterium leprae bacilli, primarily affecting the skin and peripheral nerves. Despite treatment with multidrug therapy (MDT), it remains a public health concern in many countries, particularly in South-East Asia. Early detection is essential to prevent the diseases spread and disability. Due to the multiple morphologies, it may be difficult to accurately diagnose certain cases based solely on clinical signs; therefore, histopathology is crucial for definitive diagnosis. Objectives: To evaluate the clinical and histopathological correlation with their concordance rates thereby highlighting the role of histopathology in diagnosis and management, especially in borderline leprosy (Hansens disease) cases. Methods: A retrospective study was conducted at Malla Reddy Institute of Medical Sciences from October 2023 to March 2025. Fifty-two skin biopsies from clinically suspected leprosy cases were studied using Haematoxylin Eosin and Fite-Faraco staining. Cases were classified histologically along with bacteriological index as per the Ridley-Jopling system. Concordance between clinical and histological diagnosis was statistically analysed. Results: Out of 52 cases, 61.5 were males, females contributing to 38.4. The most affected age group was 2130 years (46). Histopathological types included Lepromatous Leprosy (LL) (42.3), Borderline Lepromatous (BL) (21), and Borderline Tuberculoid (BT) (15.3). Overall concordance between clinical and histopathological classification was analysed statistically with highest agreement observed in TT (96.2) and BT (94.2) with a greater number of multibacillary cases showing acid-fast bacilli on Fite-Faraco staining. Conclusion: Accurate diagnosis using Ridley-Jopling classification integrates clinical, histological, and immunological findings which plays a pivotal role for effective management.
Cheruku et al. (Wed,) studied this question.