Leprosy: A Persistent Culprit Behind Granulomatous Dermatitis In Northern India

Background: Granulomatous skin lesions represent a distinct type of chronic inflammation characterized by the formation of granulomas. These lesions often pose diagnostic challenges due to their varied presentations and histological similarities. Accurate histopathological identification is crucial for appropriate treatment and prognosis. Aim and Objectives: The study aimed to evaluate frequency of various granulomatous skin lesions histopathologically, especially the infectious one and correlate them with clinical findings. Materials and Methods: A total of 103 skin biopsies from patients with suspected granulomatous skin lesions were studied prospectively over 12 months at the Department of Pathology, Muzaffarnagar Medical College and Hospital. Biopsies were processed, sectioned at 4-5 microns, and stained with Hematoxylin and Eosin (H&E). Special stains like Ziehl-Neelsen (ZN) and Fite-Faraco (FF) were utilized as needed. Histopathological diagnoses were made following microscopic examination. Results: Among the 103 cases, there was a male predominance with 67 cases (65%). Majority of the patients were in the age group of 21-30 years (35.9%). Infectious granulomatous lesions were predominant, accounting for 84.5% of cases, with leprosy being the most common cause (73 cases, 70.9%). A clinicopathologic concordance rate of 91.3% was observed. Conclusion: Infectious granulomatous dermatoses, particularly leprosy, remain the leading cause of granulomatous skin lesions in developing countries. Histopathology plays a pivotal role in the diagnosis and classification of these conditions, guiding effective clinical management