scholarly journals Clinico-histopathological correlation of skin biopsies in leprosy

2013 ◽  
Vol 3 (6) ◽  
pp. 452-458 ◽  
Author(s):  
U Manandhar ◽  
RC Adhikari ◽  
G Sayami
Keyword(s):  
Clinical Information ◽  
Lepromatous Leprosy ◽  
Cross Sectional ◽  
Histopathological Correlation ◽  
Granulomatous Lesions ◽  
Tuberculoid Leprosy ◽  
Special Stain ◽  
Different Types ◽  
Skin Biopsies

Background: In leprosy, there is a range of varied clinicopathologic manifestations and the diagnosis is made from adequate clinical information combined with bacilloscopy and histopathology which helps in diagnosing different types of leprosy and separating it from other granulomatous lesions. Aim of the study was to classify leprosy according to Ridley Jopling classification and perform the clinicopathological correlation. Materials and Methods: A cross sectional comparative study of skin biopsies of newly diagnosed leprosy recieved over a period of 18 months from January 2009 to June 2010 and clinicopathologic correlation was done along with special stain. Results: This study included 75 patients diagnosed clinically as leprosy. Skin biopsy revealed evidence of leprosy in 72 cases. Maximum number of patient clinically belonged to tuberculoid leprosy which constituted 25 (33%) cases followed by borderline tuberculoid 19 (25.33%). On the contrary, histologically borderline tuberculoid was the most common type (40%, n=30) cases and tuberculoid leprosy constituted (13.33%, n=10) cases. Three cases of clinically diagnosed tuberculoid leprosy showed no features of leprosy histologically. Clinical and histopathological correlation was seen in 34 cases (45.33%). The correlation was highest in borderline tuberculoid (63.15%) followed by borderline lepromatous and lepromatous leprosy. Slit skin smear was positive in 31 cases (43.05%). Fite Farraco stain was positive in 18 cases (25%). Conclusion: The classification of leprosy requires attention to the histopathological criteria and correlation with clinicalinformationand bacteriological examination so as to facilitate accurate therapy to prevent undesirable complication. DOI: http://dx.doi.org/10.3126/jpn.v3i6.8992   Journal of Pathology of Nepal (2013) Vol. 3, 452-458

scholarly journals Clinicohistopathological correlation of leprosy

2017 ◽  
Vol 7 (1) ◽  
pp. 1095-1102
Author(s):  
A Shrestha ◽  
S Chauhan ◽  
M Mathur
Keyword(s):  
Clinical Diagnosis ◽  
Clinical Information ◽  
Lepromatous Leprosy ◽  
P Value ◽  
Histopathological Diagnosis ◽  
Histopathological Correlation ◽  
The Social ◽  
Tuberculoid Leprosy

BACKGROUND: Leprosy is a chronic infectious granulomatous disease caused by Mycobacterium leprae. It is a spectral disease which is classified into five groups according to Ridley and Jopling based on clinical, histological, microbiological and immunological criteria. Adequate clinical information combined with bacilloscopy and histopathology is helpful not only in classification of different types of leprosy but also useful for management of the cases.METHOD: 50 cases of leprosy were examined and clinical data was recorded. Slit skin smears were stained with Ziehl Neelsen stain. Skin biopsy was stained with Hematoxylin-Eosin stain and Fite Farraco stain was performed to demonstrate acid fast bacilli. All patients were classified according to Ridley & Jopling classification. Clinico-histopathological correlation was done. Statistical analysis was done using SPSS (Statistical Package for the Social Sciences) 16.0.RESULTS: Most common histological type of leprosy was tuberculoid leprosy seen in 19(38%) cases followed by indeterminate leprosy. Overall clinico-histopathological correlation was seen in 39.58%. The correlation was highest in indeterminate and histoid leprosy (100%) followed by lepromatous leprosy (66.66 %%) and tuberculoid leprosy (50%). Slit skin smear showed bacilli in 12 out of 48 cases (25%) while biopsy showed bacilli in 16 out of 48 cases (33.3%).CONCLUSION: In the present study, clinical diagnosis did not correlate with histopathological diagnosis significantly (p value=0.04159). The study emphasizes the role of histopathological and bacilloscopic examination to aid the clinical diagnosis for accurate typing of leprosy cases then better management of the patient.

scholarly journals Histopathological study of cutaneous granulomas

2019 ◽  
Vol 9 (2) ◽  
pp. 1535-1541
Author(s):  
Aasiya Rajbhandari ◽  
Ram Chandra Adhikari ◽  
Shreya Shrivastav ◽  
Sudip Parajuli
Keyword(s):  
Histopathological Examination ◽  
Wide Spectrum ◽  
Cross Sectional Study ◽  
Histopathological Study ◽  
Microbial Culture ◽  
Cross Sectional ◽  
Granulomatous Lesions ◽  
Tuberculoid Leprosy ◽  
Cutaneous Granuloma ◽  
Skin Biopsies

Background: Cutaneous granulomas comprise a wide spectrum of diseases that are frequently encountered. Since clinical assessment alone is insufficient in most of the cases, skin biopsies are a basic requisite in evaluating these lesions. Histopathological examination, although helpful in deciding the nature of granulomas and etiology in most of the cases, maybe noncontributory in some cases, thus requiring further ancillary tests such as microbial culture, polymerase chain reaction. Materials and Methods: This prospective cross sectional study enrolled 109 cases of skin biopsies after histopathological confirmation of granulomatous lesions. The specimens were received at the Department of Pathology from 14th April 2017 to 13th April 2018. Results: Out of 650 skin biopsies, 109 cases (16.8%) were diagnosed as granulomatous lesions on histology. Male predilection was noted and age group of 31 to 40 years was the commonest affected. Upper extremities were more commonly involved. Leprosy was the commonest etiological agent and tuberculoid granulomas were the commonest type based on their histology. Conclusions: Leprosy was the most common cause of cutaneous granuloma followed by Tuberculosis, fungal infection and foreign body reaction. Among the cases of leprosy, borderline tuberculoid leprosy and tuberculoid leprosy were the commonest subtype.

scholarly journals Clinico-bacterial correlation of bacterial index in Hansen’s disease

2016 ◽  
Vol 6 (12) ◽  
pp. 998-1000
Author(s):  
SM Jha ◽  
AKS Dangol ◽  
S Shakya ◽  
B Jha
Keyword(s):  
Clinical Manifestations ◽  
Clinical Information ◽  
Accurate Diagnosis ◽  
Cross Sectional ◽  
Hansen's Disease ◽  
Hansen’S Disease ◽  
Tuberculoid Leprosy ◽  
Classi Cation ◽  
Leprosy Patients ◽  
Bacterial Index

Background: Leprosy has a broad spectrum of clinical manifestations. Clinical information along with Bacterial evidence is necessary to achieve accurate diagnosis. The present study was carried out to nd out clinical and bacterial correlation in various presentations according to Ridley Jopling classi cation of Hansen’s Disease. Materials and Methods: It was a hospital based cross-sectional comparative study of 72 leprosy patients over a period of 1 year and it’s clinico-Bacterial correlation was done with the help of Slit Skin Smear and clinical classi cation. Results: This study included 72 leprosy patients at various stages according to Ridley Jopling classi cation. Maximum cases belonged to Borderline Tuberculoid leprosy 28(38.88%) followed by Tuberculoid leprosy 15(20.83%). Slit Skin Smear showed 12(42.85%) of Borderline Tuberculoid and 3(20%) of Tuberculoid cases had disparity and didn’t match corresponding clinical subtype. Conclusion: Clinical features along with Bacterial index is useful in making accurate diagnosis so that appropriate treatment could be started and hence deformity and disability could be prevented. 

scholarly journals Evaluation of agreement between clinical and histopathological diagnosis of subtype of leprosy by skin punch biopsy

2020 ◽  
Vol 13 (1) ◽  
pp. 4-8
Author(s):  
Suman Poudel ◽  
Sunita Ranabhat ◽  
Gita Pun
Keyword(s):  
Mycobacterium Leprae ◽  
Punch Biopsy ◽  
Lepromatous Leprosy ◽  
P Value ◽  
Histopathological Diagnosis ◽  
Cross Sectional ◽  
Moderate Agreement ◽  
Skin Punch Biopsy ◽  
Tuberculoid Leprosy ◽  
Granulomatous Diseases

Introduction: Leprosy is chronic granulomatous disease caused by Mycobacterium leprae. Clinically diagnosed cases of leprosy can be evaluated by punch biopsy. It can be classified according to Ridley and Jopling Classification. Objective: To study the different spectrum of leprosy and its Bacillary Index (BI), evaluate the agreement between clinical and histopathological diagnosis. Materials and Methods: This is a hospital based cross sectional retrospective study done for the period of 6 months from January to June 2019. The data were subjected to kappa analysis by using SPSS version 24 to see the agreement between clinical and histopathological diagnosis. Results: Out of 62 cases of clinically diagnosed cases of leprosy three (4.83%) cases turned out to be other granulomatous diseases. According to Ridley and Jopling classification, clinical and histopathological agreement was seen in 38 (61.29%) cases. Agreement of 100% was seen in Indeterminate leprosy (IL) and Borderline tuberculoid leprosy (BT). The BI was more in Lepromatous leprosy (LL), Borderline lepromatous (BL) whereas IL, BT and Tuberculoid leprosy (TT) showed less BI. Overall there was moderate agreement between clinical and histopathological diagnosis (kappa- 0.505) which was statistically significant (p value <0.05). Conclusion: There was moderate agreement between the clinical and histopathological diagnosis of subtype of leprosy. The Bacillary load was high in LL whereas least in TT and is determined by immune system.

scholarly journals Perception of complications by spine surgeons

2020 ◽  
Vol 11 ◽  
pp. 88
Author(s):  
Asdrubal Falavigna ◽  
Jefferson Dedea ◽  
Alfredo Guiroy ◽  
Giovanni Barbanti Brodano
Keyword(s):  
Cross Sectional Study ◽  
Years Of Experience ◽  
Surgery Complications ◽  
Sectional Study ◽  
Cross Sectional ◽  
Orthopedic Surgeons ◽  
Clinical Scenarios ◽  
Different Types ◽  
Clinical Cases

Background: The perception of major versus minor complications may vary according to surgeons, institutions, and different specialties. Here, we analyzed the geographic distribution of the different types/severities of the most frequent complications in spinal surgery, and assessed how the perception of spine surgeons about postoperative complications differed. Methods: We performed a cross-sectional study using a questionnaire, we developed to encompass different clinical scenarios of surgeons’ perceptions of spine surgery complications. The survey involved the members of AOSpine Latin America (LA) (January 28, 2017–March 15, 2017). The main variables studied included: specialty, age, years of experience, country, individual surgeon’s perception of different clinical scenarios, and the surgeon’s classification of complications for each scenario (e.g., major, minor, or none). Our results from LA were then analyzed and compared to North American (NA) responses. Results: Orthopedic surgeons represented about 58.2% (n = 412) of the 708 questionnaires answered. Of interest, 45.6% (n = 323) of those responding had >10 years of experience. The countries analyzed included Brazil (31.5%), Mexico (17.5%), Argentina (14.4%), Colombia (8.0%), and Venezuela (7.6%). Four of the 11 scenarios showed consensus in the results (e.g., average being over 82.5%). A tendency toward consensus was present in 45.4% of the clinical cases, while two out of 11 clinical cases did not present a consensus among surgeons. Of interest, the perception of complications was similar between cohorts (LA 85% vs. NA 80%). Conclusion: Significant consensus in the perception of complications was observed in most of the analyzed scenarios for both LA and NA. However, within the LA data, responses to different clinical scenarios varied.

scholarly journals Granulomatous lesions of the skin

1970 ◽  
Vol 1 (2) ◽  
pp. 81-86 ◽  
Author(s):  
K Gautam ◽  
RR Pai ◽  
S Bhat
Keyword(s):  
Skin Diseases ◽  
Histopathological Examination ◽  
Skin Lesions ◽  
Diagnostic Challenge ◽  
Modes Of Presentation ◽  
Supportive Role ◽  
Granulomatous Lesions ◽  
Granulomatous Dermatitis ◽  
Skin Biopsies

Background: Granulomatous skin lesions often present as a diagnostic challenge to dermatopathologists due to various modes of presentation and identical histological picture produced by several causes. The aim of the study was to study different granulomatous skin lesions and to determine the relative frequency, the level of clinicopathologic concordance and to compare our results with those of other workers. Materials and Methods: A retrospective analysis of skin biopsies received over a period of two years from January 2007 to December 2008; was performed, and cases of granulomatous dermatitis reported on histopathological examination were reviewed along with special stains. Results: Out of a total of 1590 skin biopsies 106 (6.67%) cases were found to have a granulomatous reaction. It was common in males (63.21%) with most occurring in the fourth to fifth decades. Majority of cases (79 cases, 74.5%) were categorized as infectious granulomatous lesions with predominance of leprosy (63 cases, 79.7%) followed by tuberculosis (6 cases, 7.6%). An overall clinicopathologic concordance was seen in 97% of cases of leprosy. Conclusion: In this study leprosy is the most common cause of granulomatous skin lesions. It can be concluded that histopathology plays an important role in classification of leprosy, and in diagnosis and management of a variety of granulomatous skin diseases. Special stains play a supportive role in infectious granulomas. Keywords: Granulomatous skin lesion; Leprosy; Skin biopsy DOI: http://dx.doi.org/10.3126/jpn.v1i2.5397 JPN 2011; 1(2): 81-86

scholarly journals Study of Histomorphological Spectrum of Granulomatous Lesions of Skin

2021 ◽  
Author(s):  
Lalit Kumar ◽  
Pooja Agarwal ◽  
Tarun Mishra ◽  
Yatendra Chahar ◽  
Raj Kamal ◽  
...  
Keyword(s):  
Developing Countries ◽  
Uttar Pradesh ◽  
Giant Cells ◽  
Acid Fast Bacillus ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Granulomatous Lesions ◽  
Skin Biopsies ◽  
Inflammatory Pattern

Introduction: The granulomatous reaction is defined as a distinctive inflammatory pattern characterised by the granuloma. The term Granuloma was first coined by Virchow in 1864. The granuloma is characterised by collection of activated histiocytes, epithelioid cells and multinucleate giant cells that may or may not be rimed by lymphocytes and/or show central necrosis. The pattern of skin disease varies from one country to another and across different parts within same country. The granulomatous lesions of skin are a common and intriguing problem in developing countries. Aim:To study the histomorphological spectrum of granulomatous lesions of skin. Materials and Methods: This cross-sectional study was conducted in Department of Pathology, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India, over a period of two years (from September 2018 to September 2020). All skin biopsies coming to The Department of Pathology werefixed in 10% neutral buffered formalin for duration of 12 to 24 hours. Paraffin wax blocks were made and 3-4 micrometer section were taken and stained with Haematoxylin and Eosin (H&E), showing granulomas on histology were included in the study. On H&E, stained slide, granulomas were studied for type, morphology and site. Special stains were used for further evaluations and analysis. Results: Out of total 124 cases studied, the maximum patients 34 (27.41%) were of 11-20 years age group. The epithelioid granuloma was the most common type in 76 (61.29%) cases followed by histiocytic granuloma in 24 (19.35%). The infectious granulomatous dermatoses were the most common histological type in which tuberculosis was most common followed by leprosy. Most commonly the lesions were found to involve the whole dermis in 74 (59.68%) cases, followed by upper and mid dermis in 35 (28.23%) cases. Out of 40 cases of leprosy, 17(42.50%) cases were found Wade-Fite Stain positive. Out of total 57 cases of tuberculosis, 31 (54.38%) cases were found Acid-Fast Bacillus (AFB) positive. Conclusion: We concluded that major cause of granulomatous dermatoses in developing countries is still infectious, tuberculosis and leprosy being the leading causes. Histopathology is gold standard for diagnosis and categorisation of granulomatous dermatoses. Special stains are useful in cases of any dilemma.

scholarly journals Histomorphological Study of Leprosy with Clinical Correlation in Kumaon Region

2019 ◽  
Vol 6 (12) ◽  
pp. 4657-4663
Author(s):  
Neha Yadav ◽  
Binay Kumar ◽  
Usha Joshi ◽  
Mukesh Kumar ◽  
Saurabh Agarwal
Keyword(s):  
Histopathological Examination ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Lepromatous Leprosy ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Cross Sectional ◽  
Histopathological Correlation ◽  
Kappa Test ◽  
Bacterial Index

Background: Leprosy is a leading cause of permanent physical disability. Approx 60% of global burden of leprosy is represented by India. Histopathological examination is still considered gold standard for accurate categorization of leprosy so that timely treatment can be started. Objectives:  To categorize and correlate types of leprosy clinically and histomorphologically in Kumaon region. Methods: The present cross-sectional study of 62 cases was conducted in the Department of Pathology & Skin and V.D in a tertiary care centre of Kumaon region from August 2016 to April 2018. The cases were clinically examined and categorized according to Ridley-Jopling classification. Skin Biopsy and Slit-Skin Smear (SSS) were taken for accurate histomorphogical categorization of leprosy and assessment of bacterial index, followed by clinico-histomorphological correlation. Statistical analysis was done in term of chi-square test. Kappa test was used as agreement test for clinical versus histological classification of different type of leprosy. Results:  A total of 62 clinically diagnosed leprosy cases evaluated histopathologically. Clinically, lepromatous leprosy (LL) was the most common type of leprosy (38.70%), followed by borderline tuberculoid (30.64%). On histopathological examination, indeterminate leprosy (IL) (21 cases; 33.90%) was the most common followed by lepromatous leprosy (16 cases; 25.80%).  Overall clinico-histopathological correlation was seen in 36 cases (58. 06%) with maximum correlation seen in indeterminate leprosy (100%) and tuberculoid leprosy (TT) (100%). Conclusion: This study concludes that correlation of clinical and histopathological features along with bacterial index is more useful for accurate typing of leprosy than considering any of the single parameter alone so that early and appropriate treatment could be started.

scholarly journals Clinico-Pathological Correlation in the Classification of Leprosy

2019 ◽  
Vol 7 (2) ◽  
pp. 21-24
Author(s):  
Anuj Poudel ◽  
Anita Shah ◽  
Sulochana Khatiwada ◽  
Ashok Samdurkar
Keyword(s):  
Histopathological Examination ◽  
Clinical Information ◽  
Histopathological Diagnosis ◽  
Medical Sciences ◽  
Major Health ◽  
Histopathological Features ◽  
Clinical Presentations ◽  
Skin Biopsies ◽  
Bacterial Index

INTRODUCTION:- Leprosy is one of the major health problems in Nepal, caused by Mycobacterium leprae. Histopathological examination is considered as important tool for proper classification of the disease. This study was carried out to study the histopathological features of leprosy in skin biopsies and classify based on microscopy, bacterial index to correlate with clinical presentations. MATERIAL AND METHODS:- A retrospective observational study was done at Department of Pathology of Universal College of Medical Sciences (UCMS) Bhairahawa for 2 years from 1st November 2015 to 31stOctober 2017 and total 68 cases were analysed. Cases in which histopathological diagnosis of leprosy was made or considered differential diagnosis were selected for study. Ridley and Jopling classification was used histologically to make diagnosis of leprosy. Copies of issued histopathology reports, that are preserved in the department routinely were used to obtain data pertaining to age, sex, clinical information and histopathological findings. RESULTS:- This study included 68 patients diagnosed histologically as leprosy. Histopathological examination of the skin biopsies of 68 patients revealed that, the maximum histopathological cases 28 (41.17%) are BT followed by 15 cases (22.05%) of IL (15) and 9 (13.23%) of TT. Complete parity between clinical diagnosis and histopathology was observed in 55.88 % and disparity was seen in 44.12%. CONCLUSION:- For proper classification of Leprosy, correlation of clinical and histopathological features along with bacterial index is more useful than considering any of the single parameter.

scholarly journals Dermoscopy in Leprosy: A Clinical and Histopathological Correlation Study

2021 ◽  
pp. e2021032
Author(s):  
Alpana Mohta ◽  
Suresh Kumar Jain ◽  
Aditi Agrawal ◽  
Ramesh Kumar Kushwaha ◽  
Pritee Sharma ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Correlation Study ◽  
Lepromatous Leprosy ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
Histopathological Correlation ◽  
Clinical Presentations ◽  
Study Results ◽  
Vascular Structures

Background: Leprosy, an insidious infectious granulomatous disease, is diagnosed traditionally through clinical examination coupled with skin smears and histopathology. It has myriad clinical presentations that pose diagnostic challenges. Lately, dermoscopy has emerged as a rapid, noninvasive diagnostic modality for many dermatoses. Objectives: We evaluated the dermoscopic findings of various manifestations of leprosy and correlated them with clinical and histopathological features. Methods: This prospective, cross-sectional study was conducted in our skin outpatient department for a period of 1 year. Patients newly diagnosed as having leprosy or those undergoing leprosy treatment for less than 6 months were included. The most representative lesion was dermoscopically evaluated and later biopsied. Results: We included 73 patients in the study. Results indicated an obvious correlation between dermoscopic findings and histopathology. We noted orangish yellow and white structureless areas, steadily throughout the spectrum, depicting dermal granuloma. Additionally, we observed focal vascular structures such as branching, linear, and crown vessels that result from the pressure of granuloma pushing the dilated vessels upwards. The relative absence of skin appendages aided in differentiating leprosy from other granulomatous disorders. Novel findings of our study were the detection of a branch-like pattern of clofazimine-induced pigmentation on dermoscopy and orange globules on onychoscopy. Other unique findings included violaceous structureless areas, characteristic large telangiectatic vessels, follicular plugging, star-shaped silvery-white scaling, and white globules in type 1 reaction; white shiny steaks were observed in patients with borderline lepromatous leprosy, and central white dots and keratotic plugs were observed in patients with histoid leprosy. Conclusions: Dermoscopy, as a noninvasive modality, could aid in the quick diagnosis of leprosy and should be used as a handy tool to complement other investigative tools for this disease.

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