Giridhar M, Arora G, Lajpal K, Singh Chahal K
Department of Pathology, Maharaja Agarsen Medical College, Agroha, Hisar, Haryana.
Indian J Lepr. 2012 Jul-Sep;84(3):217-25.
Leprosy is a treatable chronic infectious disease, prevalent in South Asian countries, especially India. Before labeling a patient as a case of leprosy and starting multidrug treatment for particular type, the clinical findings should be correlated and confirmed with histopathological examination and bacteriological index of skin biopsy. Skin biopsy is an important tool in diagnosing leprosy and determining the type of leprosy. In the present study, one hundred untreated clinically diagnosed cases of leprosy were studied according to Ridley-Jopling scale for confirmation of diagnosis and classification of leprosy. The study was done by routine H & E (Haematoxylin & Eosin) staining and Fite-Faraco's staining for acid-fast bacillus. The data pertaining to age, sex, clinical and histopathological classification of the type of leprosy were collected and analyzed. In analyzing the histopathology of a lesion, special attention was given to the following features, viz., invasion of the epidermis with or without erosion, involvement of the sub-epidermal zone, character and extent of granuloma, density of lymphocytic infiltrate epithelioid cells and other cellular elements, nerve involvement and the presence of Mycobacterium leprae. Histological diagnosis of leprosy was established in 98% of clinically diagnosed cases. Clinicohistopathological concordance was maximum in LL(93.75%) followed by BL(87.5%), TT(78.5%), BT(73.8%) and least in IL(27.78%). Overall, it was 60.23%. Indeterminate type of leprosy was diagnosed more on histologythan on clinical evaluation.
麻风病是一种可治疗的慢性传染病，在南亚国家，尤其是印度流行。在将患者标记为麻风病病例并开始针对特定类型进行多药治疗之前，临床发现应与皮肤活检的组织病理学检查和细菌学指数相关联并得到证实。皮肤活检是诊断麻风病和确定麻风病类型的重要工具。在本研究中，根据里德利 - 乔普林量表对100例未经治疗的临床诊断麻风病病例进行研究，以确认诊断和麻风病分类。该研究通过常规苏木精和伊红（H&E）染色以及用于抗酸杆菌的菲特 - 法拉科染色进行。收集并分析了与年龄、性别、麻风病类型的临床和组织病理学分类有关的数据。在分析病变的组织病理学过程中，特别关注以下特征，即表皮有无侵蚀的浸润情况、表皮下区域的累及情况、肉芽肿的特征和范围、淋巴细胞浸润上皮样细胞及其他细胞成分的密度、神经受累情况以及麻风分枝杆菌的存在情况。98%的临床诊断病例建立了麻风病的组织学诊断。临床组织病理学一致性在瘤型麻风（LL）中最高（93.75%），其次是界线类偏瘤型（BL，87.5%）、结核样型（TT，78.5%）、界线类偏结核样型（BT，73.8%），在未定类（IL）中最低（27.78%）。总体而言，一致性为60.23%。未定类麻风在组织学上比临床评估中诊断得更多。
