Vol. 8, Issue 4, Part B (2025)

Background: Hansen's disease (HD) remains a significant public health concern with variable clinical presentations. Accurate histopathological diagnosis is essential for appropriate management.
Aims and Objective: This study aimed to characterise the spectrum of histopathological lesions in Hansen's disease.
Methods: A retrospective study was conducted in the Department of Pathology (Histology section), at B.J. Medical College and Civil Hospital, Ahmedabad, from June 2024 to December 2024, including a total of 100 cases were included. All the received punch biopsy specimens were processed and stained with Hematoxylin & Eosin and Fite-Faraco stains, and then evaluated under a microscope. Histological classification was done according to the Ridley-Jopling system, and bacterial index was determined using the logarithmic scale.
Results: The most common form was Lepromatous Leprosy (37%), followed by Tuberculoid Leprosy (30%), and Borderline Leprosy (24%). Male-to-female ratio was 1.7:1, with peak incidence in the 31-40 years age group (29%). Neural involvement was present in 70% of cases, being highest in Lepromatous Leprosy (78.37%). Multibacillary cases comprised 61% of the study population. Lepra reactions were observed in 12% of cases, with Type II (ENL) reactions being more common (83.33%) than Type I reactions (16.67%).
Conclusion: Histopathological examination remains the gold standard for Hansen's disease diagnosis and classification. The identification of the immunopathological spectrum from tuberculoid to lepromatous forms and the detection of reactive episodes are crucial for accurate classification and therapeutic intervention. This study emphasises the indispensable role of histopathology in definitive diagnosis, particularly in borderline and indeterminate forms.