ANALYZING THE CONCORDANCE OF HISTOPATHOLOGICAL FINDINGS & CLINICAL ASSESSMENT WITH BACTERIOLOGICAL INDEX IN SLIT SKIN SMEARS IN HANSEN’S DISEASE

Abstract

Background: Leprosy or Hansen’s Disease caused by Mycobacterium Leprae, a chronic
granulomatous disease, is one of the oldest diseases known to mankind. This study highlights
utility of Bacteriological Index in slit skin smears in diagnosing and its concordance with
clinical & histopathological changes in Hansen’s disease. Materials & Methods: A Crosssectional study of 60 patients clinically suspected of or diagnosed with Leprosy visiting
outpatient department of dermatology, venereology and leprology during period of February
2022 to April 2024 was conducted. Demographic data, presenting complaints, clinical
diagnosis, slit skin smear reports and histopathological diagnosis of leprosy patients was
collected from case-sheets and registers. Bacteriological Index was noted from slit skin smear
reports. Histopathological details of skin biopsies was collected. Data was categorised &
analysed to assess concordance Aim: To study concordance of histopathological findings and
clinical assessment with bacteriological index in slit skin smears in different types of Leprosy
Results:
1. Out of 60 clinically suspected patients, maximum of 21 patients (35%) were in third
decade and male predominance with 39 cases (65%)
2. On histopathological examination, 57 cases were positive for Hansen’s disease. 19cases
were Borderline Tuberculosis (31.6%)
3. Slit skin smears demonstrated AFB in 34 cases (56.6%) and maximum sensitivity of
91.6% in lepromatous leprosy
4. In study, highest concordance of bacillary index with histopathological findings was seen
in lepromatous leprosy (90%) followed by borderline cases
5. Clinico-histopathological concordance was maximum in lepromatous leprosy (82%) and
borderline tuberculoid (78%)
Conclusion:
1. Leprosy patients vary in clinical & histopathological features depending on host immune
response.
2. Correlation of histo-morphological findings with slit skin smear will be helpful for better
patient management.