Dermatoscopy In Hansen’s Disease and Its Correlation with Clinical Spectrum and Histopathology: An Observational Study

Abstract

Introduction: Hansen’s disease is a chronic granulomatous infection of the skin and peripheral nerves with a broad clinicopathological spectrum, often leading to diagnostic delay due to its varied presentation. Dermoscopy is a non-invasive bedside tool that may assist in spectrum-based evaluation. The present study aimed to assess dermoscopic features across the clinical spectrum of Hansen’s disease and correlate them with clinical and histopathological findings.

Methodology: An observational cross-sectional study was conducted over eighteen months in the Department of Dermatology, Integral Institute of Medical Sciences and Research, Lucknow. Seventy patients clinically diagnosed with Hansen’s disease and supported by slit skin smear examination were included. Detailed clinical assessment, dermoscopic evaluation, slit skin smear analysis, and histopathological examination were performed, and findings were correlated across disease spectra.

Results: Most patients were aged twenty to forty-nine years, with male predominance and predominantly lower socioeconomic status. Hypoesthesia was the commonest presentation, with asymmetrical, plaque-predominant lesions and frequent surface changes. The ulnar nerve was most commonly involved. Borderline tuberculoid Hansen’s disease was the predominant clinical, dermoscopic, and histopathological subtype. Yellow–orange areas were the most frequent dermoscopic finding, while AFB positivity and lymphocytic infiltrate predominated histologically. Dermoscopic findings showed a significant association with histopathology (p = 0.004; OR = 11.25).

Conclusion: Dermoscopy enhances diagnostic confidence in Hansen’s disease by supporting spectrum-based assessment and improving clinico-histopathological correlation. Its routine integration may aid early diagnosis and guide biopsy decisions.