Histopathological spectrum of Leprosy – A prospective study

Introduction: Leprosy, caused by Mycobacterium leprae, remains a major public health issue in developing countries, affecting various organs. Multi-drug therapy (MDT) has significantly reduced cases, including Dapsone-resistant strains. Leprosy lesions are classified based on immune response into five types. This study aims to explore the histological types of leprosy. Methods: This prospective study, conducted at Mamata Academy of Medical Sciences, Hyderabad, from January 2023 to August 2024, included clinically diagnosed or suspected leprosy cases aged >18 years. Demographic data, clinical findings, and skin biopsies were recorded. Histopathological analysis, using H&E and Fite-Faraco staining, followed Ridley-Jopling classification and bacillary index. Results: Out of 52 leprosy cases, the majority (53.8%) were aged 21–40 years, with a male-to-female ratio of 1.3. Hypopigmented patches were the most common clinical finding (61.5%), followed by erythematous lesions (28.8%) and nerve thickening (9.6%). Histologically, BT was the most frequent type (34.6%), followed by BL (23.1%). Conclusion: This study highlights the importance of histopathological classification in leprosy diagnosis. The most common histological types were BT and BL, with strong clinical and histopathological correlation, especially for TT. Early diagnosis and appropriate treatment, including MDT, remain crucial in managing leprosy and preventing further complications.