Leprosy presents with a spectrum of skin lesions varying from an insignificant patch to extensive lesions causing disabilities. It necessitates histopathology and bacteriological studies to diagnose and differentiate it from other skin lesions. A histopathological confirmation along with bacillary load estimation can help in early accurate diagnosis and timely treatment to reduce the disability caused. In most of the cases, the clinical and histopathological findings show discordance thereby causing hindrance in diagnosis and delayed treatment. This study was done to categorize Leprosy to subtypes based on clinical and also histopathological types and to study the concordance rates, clinically and histopathologically. Aim of the study is to determine the concordance rate of diagnosis of cutaneous leprosy, clinically and histopathologically using Ridley Jopling classification. It is an ambispective observational study of biopsies obtained from clinically suspected leprosy patients between January 2013 and December 2015. The clinical findings were analyzed against histopathological diagnosis. The level of concordance between clinical and histopathological types was estimated by Cohen’s kappa. Out of 296 biopsies analyzed 235 (79%) were histopathologically confirmed for leprosy. The males had increased preponderance (64%) and the affected age group was 21-40 years (48%). Only 72 cases of 235 cases showed AFB (acid fast bacilli) positivity by FiteFaraco staining. There was a fair level of agreement between clinical and histopathological typing of leprosy by Ridley Jopling classification (k=0.302). The agreement between clinical and histopathological types was only fair, and overall agreement in diagnosing leprosy was 79%. Accurate diagnosis of leprosy clinically alone cannot be assured, and should be accompanied by histopathology till a highly specific diagnostic test is available.

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