Diagnostic value of in situ polymerase chain reaction in leprosy

Abstract

Objective: This prospective study was carried out to assess the diagnostic value ofin situ Polymerase Chain Reaction in leprosy, particularly in enhancing the histopathological diagnosis. Method: Clinical examination of 20 patients (< 16 yr) was done and skin smear for AFB was prepared. Biopsy of lesion site was taken for histopathological examination andin situ PCR testing. Results: The histopathological examination confirmed the clinical diagnosis in 45% cases only; non-specific histopathology was reported in the remaining 55% cases.In situ PCR showed a positivity of 57.1% in early/ localized form of leprosy (IIBT) and 61.5% in (BB/BL) group. When compared to histopathology examination, a significant enhancement of 15% in diagnosis was seen. Within situ PCR, the diagnosis could be confirmed in 4/11 (36.3%) cases with non-specific histopathological features, (which is common in early disease) in addition to confirmation of 8/9 (88.8%) histopathologically-confirmed tissue sections. Histopathology andin situ PCR, combined together, confirmed the diagnosis in 13/20 cases (65% of total cases). Conclusion: Thus,in situ PCR is an important diagnostic tool especially in early and doubtful cases of leprosy.