CLINICAL AND HISTOPATHOLOGICAL CORRELATION IN THE CLASSIFICATION OF LEPROSY

This study reports our observations on the correlation between clinica l and histopathological diagnoses of the classification of leprosy. Th e histopathological classification of leprosy in 1351 cases was done p er Ridley-Jopling criteria and was compared with the clinical diagnose s of the same cases. These 1351 cases included 79 cases diagnosed clin ically as having a ''reaction.'' However, the histopathologists could not detect any evidence of reaction in 16 of these 79 cases (20%). Of the remaining 1272 cases, 68 (5%) were reported as ''no evidence of le prosy'' by the histopathologists; 37 of these 68 were found to be from the clinically indeterminate type of leprosy. Histopathological and c linical diagnoses of the classification of leprosy coincided in 69% of the cases. Concordance between the clinical and histopathological dia gnoses for different types of leprosy was: indeterminate (I) = 36%, tu berculoid (TT) = 50%, borderline tuberculoid (BT) = 77%, borderline (B B) = 26%, borderline lepromatous (BL) = 43%, and lepromatous (LL) = 91 %. When some of the types were combined (BT with TT, BL with LL), the overall concordance figure was 76%; concordance for the TT/BT group wa s 80%, for the BL/ LL group it was 93%. Since both TT and BT are consi dered paucibacillary and LL or BL are considered multibacillary for tr eatment purposes, differentiating TT from BT or BL from LL is, perhaps , therapeutically irrelevant. However, for classification purposes it appears that the weight given to different signs and/or histopathologi cal parameters for classifying leprosy cases (especially TT, BB and I) needs to be reassessed.