Histology and immuno-histology of lesions clinically suspicious of leprosy.

Abstract

Forty-six patients presenting with lesions clinically suspicious of leprosy were selected among patients attending the outpatient department (OPD) of our Institute. The lesions were biopsied deeply for histological analysis. The cases chosen commonly belonged to the 20-35 years age group, were predominantly males, with rare cases of leprosy within the family (2/46, 4.35%). The clinical presentation in most of the cases was that of a solitary lesion, (44/46, 95.65%) located in one of the extremities (40/46, 86.95%). A positive Mitsuda reaction could be elicited in 40% of the cases. Routine histopathologic analysis using defined criteriae, has established the diagnosis of leprosy in 16/46 (34.78%) cases with positivity for acid-fast bacilli in 4 cases. The remaining cases (25/46, 54.35%) exhibited a non-specific histopathology with a perivascular/periadnexal mononuclear cell infiltrate, few (5/46, 10.86%) exhibited minimal or no histopathological features. The sections with nonspecific or minimal pathology when immunostained for the presence of mycobacterial antigen exhibited positivity in 11/30 (36.6%) cases. Presuming the features observed to be consequent to the presence of antigens nearby, the diagnosis of leprosy was significantly enhanced compared to the diagnosis achieved with routine histopathology alone.