[Analysis of inter and intrapathologist concordance and discordance in a comparative study of the Madrid and Ridley-Jopling classifications of leprosy].

Eighty-six patients of leprosy have been examined by three leprologists; they have been classified according to the Madrid classification and their lesions biopsied and sent to two pathologists for independent histopathological examination. The pathologists have not received any information regarding the cases. Firstly the "senior" pathologist (A) utilized the Madrid classification and the "junior" pathologist (B) the Ridley-Jopling classification. In a second phase, the "senior" pathologist utilized the Ridley-Jopling classification and the "junior" pathologist the Madrid classification. Both pathologists did not know their own previous histopathological diagnosis at the second phase. The analysis of concordance and discordance between the histopathological diagnosis of the two pathologists and for the same pathologist, on utilizing the two classifications, have elicited the following conclusions: 1. There has been more concordance between the two pathologists on utilizing the Madrid classification than the Ridley-Jopling classification for the lepromatous, borderline and tuberculoïd in reaction patients. 2. The comparison of the two classifications for each pathologist on "blindly" examination of the material, has shown more concordance for the "senior" pathologist than for the "junior" pathologist. 3. These observations have convoyed to the final conclusion that the Ridley-Jopling classification brings some difficulties to the pathologists with limited experience in leprology and therefore it should be utilized only by experienced pathologists. 4. This preliminary study shows the necessity of performing another one with larger number of patients, in the active phase, with larger number of pathologists, preferably from different countries, and by utilizing the same methodology of "blind" examination of the material.