Role of histopathology in predicting type 1 lepra reaction in borderline tuberculoid leprosy

Context: Lepra reactions if not managed promptly are an important cause of sudden onset nerve palsy and disability due to leprosy. Aim: To evaluate the usefulness of histology in predicting type 1 lepra reaction. Setting and Design: After obtaining clearance from institutional research and ethics co...

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Main Authors: Dhanya Sankaran (Author), Sarita Sasidharanpillai (Author), Kidangazhiyathmana Ajithkumar (Author), Aparna Govindan (Author), Ekkila Valappil Seemi (Author), Puthen Parambath Sathi (Author)
Format: Book
Published: Wolters Kluwer Medknow Publications, 2020-01-01T00:00:00Z.
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Summary:Context: Lepra reactions if not managed promptly are an important cause of sudden onset nerve palsy and disability due to leprosy. Aim: To evaluate the usefulness of histology in predicting type 1 lepra reaction. Setting and Design: After obtaining clearance from institutional research and ethics committees, all histologically proven borderline tuberculoid patients diagnosed at our center from 1.8.2016 to 31.7.2018 were included in this retrospective cross-sectional study. Method: Clinical details were collected from patient records. The pathologist who was blinded to clinical evidence of type 1 lepra reaction at the time of biopsy re-evaluated the histopathology slides for evidence of type 1 reaction. The data of individual patient was analyzed to identify those who had a type 1 reaction at the time of the biopsy or who developed a lepra reaction during follow up. Statistical Analysis Used: Association between histological evidence of type 1 reaction and clinical manifestation of the same subsequently, was assessed using Pearson's Chi square test. Results: Study group comprised of 22 females and 18 males. Clinicohistological concordance was noted in 27 patients (67.5%). Subclinical type 1 reaction was documented in 11 patients (27.5%) based on histopathology evaluation. Five (45.5%) of these 11 patients subsequently developed clinical features of type 1 reaction. This was found to be statistically significant (P value 0.02). Limitations: Main limitation was the small sample size. Conclusions: Histology could serve as a useful tool in predicting future type 1 lepra reaction.
Item Description:2229-5178
10.4103/idoj.IDOJ_423_19