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Significance of Histopathology in Leprosy Patients with 1–5 Skin Lesions with Relevance to Therapy

Veena S, Kumar P, Shashikala P, Gurubasavaraj H, Chandrasekhar HR - J Lab Physicians (2011)

Bottom Line: For betterment and adequate treatment of patients, this grouping needs further study.AFB were found in 2 (6.45%) out of 31 skin biopsies.Clinicopathological correlation was 76.6% in the BT group.

Affiliation: Department of Pathology, Kasturba Medical College, Manipal, Karnataka, India.

ABSTRACT

Background: Patients with 1-5 skin lesions are clinically categorized as paucibacillary for treatment purposes. For betterment and adequate treatment of patients, this grouping needs further study.

Aim: To study a group of leprosy patients with 1-5 skin lesions, compare clinical details with histopathological findings and bacteriological status of the skin to evaluate the relevance of this grouping.

Materials and methods: Two-year study involving 31 patients of leprosy with 1-5 skin lesions was included in this study. A number of skin lesions were recorded. Skin biopsies were taken in all patients. The biopsies were evaluated for the type of pathology and acid fast bacilli (AFB) status.

Results: Of 31 patients, 19 (61.2%) had single skin lesion, 7 (22.5%) had two lesions, 4 (12.9%) had three lesions, and only one (3.22%) had four lesions, there were no patients with five lesions. Of the 31 patients, 30 (96.7%) were clinically diagnosed as borderline tuberculoid and one patient (3.22%) has tuberculoid leprosy. Skin smears were negative for AFB in all patients. The histological diagnoses were: TT 1 (3.22%), BT 24 (77.41%), and IL 6 (19.2%). AFB were found in 2 (6.45%) out of 31 skin biopsies. Clinicopathological correlation was 76.6% in the BT group.

Conclusion: Tissue biopsy findings in 1-5 skin lesions which were not considered relevant for treatment purposes until now should be given a status in the categorization and assessment of severity of the disease. The significance of finding of AFB and histopathology of multibacillary (MB) type of leprosy in tissue biopsies, in patients grouped as PB should be resolved so that patients could be given the drug therapy and duration of therapy they warrant.

Fite faraco stain – AFB in nerve twig, H and E; 40×
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Figure 5: Fite faraco stain – AFB in nerve twig, H and E; 40×

Mentions: The histopathological findings of H and E stained skin biopsies were as follows: TT (1), BT (23) [Figures 2–5] IL (6) patients. The BIG values on modified Fite stain were 1+ in two biopsies which showed features of BT on histopathology [Table 1].

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Significance of Histopathology in Leprosy Patients with 1–5 Skin Lesions with Relevance to Therapy

Veena S, Kumar P, Shashikala P, Gurubasavaraj H, Chandrasekhar HR - J Lab Physicians (2011)

Fite faraco stain – AFB in nerve twig, H and E; 40×
© Copyright Policy - open-access
Figure 5: Fite faraco stain – AFB in nerve twig, H and E; 40×
Mentions: The histopathological findings of H and E stained skin biopsies were as follows: TT (1), BT (23) [Figures 2–5] IL (6) patients. The BIG values on modified Fite stain were 1+ in two biopsies which showed features of BT on histopathology [Table 1].

Bottom Line: For betterment and adequate treatment of patients, this grouping needs further study.AFB were found in 2 (6.45%) out of 31 skin biopsies.Clinicopathological correlation was 76.6% in the BT group.

Affiliation: Department of Pathology, Kasturba Medical College, Manipal, Karnataka, India.

ABSTRACT

Background: Patients with 1-5 skin lesions are clinically categorized as paucibacillary for treatment purposes. For betterment and adequate treatment of patients, this grouping needs further study.

Aim: To study a group of leprosy patients with 1-5 skin lesions, compare clinical details with histopathological findings and bacteriological status of the skin to evaluate the relevance of this grouping.

Materials and methods: Two-year study involving 31 patients of leprosy with 1-5 skin lesions was included in this study. A number of skin lesions were recorded. Skin biopsies were taken in all patients. The biopsies were evaluated for the type of pathology and acid fast bacilli (AFB) status.

Results: Of 31 patients, 19 (61.2%) had single skin lesion, 7 (22.5%) had two lesions, 4 (12.9%) had three lesions, and only one (3.22%) had four lesions, there were no patients with five lesions. Of the 31 patients, 30 (96.7%) were clinically diagnosed as borderline tuberculoid and one patient (3.22%) has tuberculoid leprosy. Skin smears were negative for AFB in all patients. The histological diagnoses were: TT 1 (3.22%), BT 24 (77.41%), and IL 6 (19.2%). AFB were found in 2 (6.45%) out of 31 skin biopsies. Clinicopathological correlation was 76.6% in the BT group.

Conclusion: Tissue biopsy findings in 1-5 skin lesions which were not considered relevant for treatment purposes until now should be given a status in the categorization and assessment of severity of the disease. The significance of finding of AFB and histopathology of multibacillary (MB) type of leprosy in tissue biopsies, in patients grouped as PB should be resolved so that patients could be given the drug therapy and duration of therapy they warrant.

View Similar Images In: Results  - Collection
View Article: PubMed Central -  PubMed
Show All Figures - Show MeSH
getmorefigures.php?pmc=3118051&rFormat=json&query=null&req=5