Bacterial index of granuloma and its relevance compared to BI of skin smears.

Editor, The importance of accurate histopathological assessment of type of leprosy with the help of skin biopsy is emphasized by the widespread poor performance of slit skin smears (SSS). Many workers have reported ®nding AFB more frequently in skin biopsies compared with slit skin smears in all types of leprosy. However, the presence of AFB in skin biopsy has been assigned no role in grading of leprosy or as a guide in treatment, probably because it is dif®cult to perform skin biopsies in large numbers of patients. As the number of leprosy patients is decreasing world-wide, it may be possible to assign a future role for these ®ndings. Here, we compared the bacterial indices (BI) of slit skin smears with the Bacterial Indices of Granuloma (BIG) of skin biopsies of leprosy patients. One hundred and eight leprosy patients (80 male and 28 female) from department of Dermatology, Osmania General Hospital, Hyderabad, India were studied between January and December, 1998. The clinical types of leprosy were TT, 1; BT, 61; BB, 2; BL, 24; LL, 12; and Indeterminate, 4. Slit skin smears and skin biopsies were performed on the same lesion in all the patients. Skin biopsies were stained by H&E stain and modi®ed Fite stain. BIG in these slides were assessed as per Ridley's scale for granuIomas.