A STUDY OF CLINICO-PATHOLOGICAL CONCORDANCE IN PATIENTS WITH HANSEN’S DISEASE ACROSS THE SPECTRUM
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 49
Abstract
BACKGROUND Leprosy is a disease showing wide variations in its clinical presentations and disparities between clinical and histopathological presentations. The aim of this study was to assess the extent of correlation between clinical and histopathological diagnosis in cases diagnosed with leprosy. MATERIALS AND METHODS The primary objective was to study the concordance between clinical and histopathological presentations of Hansen’s disease across the spectrum and to assess the rate of concordance between them. It was a descriptive study done in the Department of Dermatology and Venereology, Medical College, Thiruvananthapuram for a period of 1½ years (From November 2012 to May 2014). All new (Untreated) cases of Hansen’s disease who attended the department during the study period were included in the study. RESULTS A total of 45 patients were included in the study, but since one patient showed inconclusive histopathological features of leprosy he was eliminated and statistical analysis was done in 44 cases. In general, clinico-pathological concordance was observed in 63.6% of cases and discordance was observed in 36.4% of cases; 100% concordance was seen in indeterminate and tuberculoid cases and 100% discordance was observed in borderline lepromatous and histoid cases. Concordance rate was high in borderline tuberculoid (77.8%) and discordance rate was high in lepromatous cases (57.1%). Limitation- The main limitation of this study was the small sample size, as many cases in this part of the country were treated at peripheral centres and there were no facilities for co-ordination with such centres for a more elaborate study. CONCLUSION The overall concordance was 63.6% and discordance was 36.4%, which was similar to most of the previous studies; 100% concordance was observed in indeterminate and tuberculoid cases, whereas 100% discordance was observed in borderline lepromatous and histoid cases. Wide variations in clinico-pathological correlation was shown by borderline lepromatous cases, where the histopathological types showed features of borderline tuberculoid. Variations in clinico-pathological correlation was shown by borderline lepromatous cases, where the histopathological types showed features of borderline tuberculoid and mid borderline.
Authors and Affiliations
Lakshmy R, Abdul Samad K, Nandakumar G, Joan Felicita Samson
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