Introduction: Leprosy is a major public health problem in developing countries including India. It is caused by Mycobacterium leprae and predominantly affects skin and peripheral nerves. It is a chronic disease having varied clinical and also varied biopsy findings. Aim of the study: (a) To analyse the histopathological spectrum of Hansens’s disease based on the histopathological and clinical features. (b) To study clinicohistopathological correlation. Materials and Methods: This was a retrospective and prospective study carried out at Subharti Medical College, Meerut, Uttar Pradesh, over a period of four and half years. All the skin biopsies obtained from patients clinically diagnosed or suspected as having leprosy were studied by way of histopathological examination and Fite stain. The age and gender distribution, sites of lesions, types on histopatholgy, Fite stain positivity and the types of reactions were studied. Results: A total of 216 (17.2%) cases of leprosy were diagnosed among 1255 total skin biopsies. The male to female ratio was 2.27:1. The most common age group was 2130 years, the most common sites were the extremities and most common presentation was as hypopigmented macules. The lepromatous type was the most common on histopathology and the midborderline was the least common. All lepromatous cases were positive for Fite stain. Erythema nodosum leprosum was seen in 30 (13.8%) cases. Conclusion: All cases of clinically suspected leprosy should undergo skin biopsy for histopathological examination and special stain to demonstrate the acid fast bacillus. The indeterminate type shows nonspecific findings on skin biopsy. Reversal reactions and Erythema nodosum leprosum are quite common in leprosy requiring hospital admission to prevent complications.

Keywords: Hansen’s Disease; Histopathology; Bacillary Index; Skin Biopsies; Leprosy Reactions.