Leprosy, a chronic infectious disease caused by Mycobacterium leprae, is one of the major public health problems in India though the prevalence is declining with multidrug therapy . The spectrum of disease in leprosy has been characterized in a number of clinico–immunopathological classification systems, the most widely used being the Ridley– Jopling classification

OBJECTIVES: (i) To correlate clinical diagnosis with histopathological diagnosis of leprosy, (ii) To study the histopathological spectrum of leprosy according to Ridley–Jopling classification, (iii) To study bacterial index in different types of leprosy

METHODS: A retrospective study of one year from August 2012 to July 2013 was conducted. Among which suspected, diagnosed and relapsed cases of leprosy were included. Skin biopsy from active lesions was taken and stained with Hematoxylin and Eosin, Modified FiteFarraco was done for identification of Mycobacterium Leprae. The histopathological findings were compared with clinical diagnosis.

RESULTS: A total 104 skin biopsies were studied, out of which 60 (76 %) were males and 19 (24 %) were females between 11 and 80 years. The majority were (60.9%)in the age group of 21 to 40 years. In our study 79 (75.9%) cases were confirmed as leprosy on biopsy. Majority were Lepromatous leprosy (LL– 39) followed by borderline tuberculoid  leprosy (BT– 30), borderline lepromatous  leprosy (BL–5), tuberculoid leprosy (TL–3), indeterminate (2). The clinico–histomorphological concordance was maximum in lepromatous polar form . Two cases diagnosed as leprosy turned out to be fungal folliculitis and a single case of  vasculitis.

CONCLUSION: Due to its clinical diversity as well as its ability to mimic other diseases sometimes leprosy is difficult to diagnose clinically. Hence skin biopsy is a useful tool in confirming the clinical diagnosis of leprosy as well as for thetherapeutic guide