Two cases of exorbitant clinicohistopathological discordance of leprosy

Abstract

Leprosy is a chronic infectious disease caused by Mycobacterium leprae. It is an infectious disease primarily affecting the skin and the nerves. It presents with varied clinical presentation and their histopathological examination is considered as the gold standard for diagnosis, since cellular characteristics in leprosy lesions are related to the immunological status of the patient. Ridley and Jopling proposed a classification which includes the clinical, histological and immunological spectrum and it has been widely accepted. But rarely, the clinical presentation does not correspond with the histopathological classification, which is known as “discordance of leprosy”. We report two cases of leprosy where there was an extreme degree of discordance, because the patients presented with clinical features of lepromatous leprosy but turned out to have tuberculoid leprosy on histopathology.