Analysis of relapse and its clinico - histopathological correlation – a retrospective study from The Leprosy Mission Hospital , Purulia Joydeepa Darlong

Objectives To study the clinical profile of patients diagnosed with relapsed leprosy using WHO guidelines Correlate their bacteriological and histopathological findings . Discussion of Drug resistance profile in this cohort of patients

Methodology Suspects - All patients who had successfully completed treatment with WHO MDT in the past, reporting with clinical signs of progression of disease. Confirmed cases – Defined by Who guidelines and Slit Skin smear +ve with confirmed biopsies . Data Collection was done from patient medical records and computerized hospital information system on patients diagnosed with relapse from 2009 to 2015. Entered into excel sheets and analyzed

Presenting complaints

Years free of disease

Resistance profile 15 relapsed patients underwent resistance study 4 had rifampicin resistance 1 had dapsone resistance .

Discussion Leprosy is common in males , a similar trend is seen in relapse. Patch is the commonest symptom (51%) explained by cosmetic reasons . Edema and infiltration must not be ignored. They are subtle signs of LL leprosy . BL and LL are the commonest classification . Unless bacteriological index and histopathological examination is done , chances of missing a correct diagnosis is high .

Conclusion Histopathological study of relapsed leprosy is very important in understanding the disease, its varied manifestations . It will enable correct classification , hence appropriate treatment . Cases presenting with new patches and neuritis might get missed if not correlated with BI and Biopsy . Resistance studies must be done in all relapsed cases If resistance to any antibiotic is obtained , then alternate treatment regimes must be offered .