Comparative evaluation of slit-skin smear with punch biopsy for diagnosing leprosy in suspected patient attending a tertiary care hospital in peripheral West Bengal

Shuvankar Mukherjee; Arijit Sarkar; Suchitra Mishra

doi:10.5455/njppp.2023.13.12564202329122023

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Original Research
Online Published: 09 Jan 2024

Natl J Physiol Pharm Pharmacol. 2024; 14(7): 1281-1284

doi: 10.5455/njppp.2023.13.12564202329122023

Comparative evaluation of slit-skin smear with punch biopsy for diagnosing leprosy in suspected patient attending a tertiary care hospital in peripheral West Bengal

Shuvankar Mukherjee, Arijit Sarkar, Suchitra Mishra.

Abstract
Background: Leprosy usually remains underdiagnosed or over-diagnosed due to a high dependency on clinical expertise. Leprosy requires a simple easy-to-perform laboratory test that guides clinicians to come to a conclusion with clinical correlation. Punch biopsy is the gold standard but it requires a biopsy facility in a hospital setting. Molecular diagnosis is out of reach even in resource-rich setups due to the non-availability of commercial kits. In this context slit-skin smear (SSS) might be an easier alternative to guide clinicians for a quality diagnosis, especially in peripheral hospitals.

Aims and Objectives: To determine diagnostic sensitivity and specificity of SSS with respect to punch biopsy.

Materials and Methods: The present study is an observational cross-sectional study conducted in a teaching institute in peripheral West Bengal. Two samples from clinically suspected patients of leprosy were collected for SSS and punch biopsy. Tests were performed as per standard laboratory protocol. Positive cases were informed to the clinician and treated as per World Health Organization treatment guidelines. SSS was compared to a punch biopsy with respect to sensitivity, specificity, positive predictive value, and negative predictive value.

Results: Twenty-five among 59 clinically suspected cases were positive by either two tests or only one test. Twenty-one were males and four were female. Thirty-six was the median age distribution in positive cases 19 cases were positive by both SSS and punch biopsy, five by punch biopsy only, and one by SSS only. Sensitivity and specificity were 79.17% and 97.14%, respectively.

Conclusion: SSS is not inferior to punch biopsy even in paucibacillary cases. It is a simple easy-to-perform test but requires training and awareness in medical personnel to make it a front-line weapon to combat continuous leprosy transmission in the community.

Key words: Leprosy; Slit-skin Smear; Punch Biopsy; Positivity

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Pubmed Style

Mukherjee S, Sarkar A, Mishra S. Comparative evaluation of slit-skin smear with punch biopsy for diagnosing leprosy in suspected patient attending a tertiary care hospital in peripheral West Bengal. Natl J Physiol Pharm Pharmacol. 2024; 14(7): 1281-1284. doi:10.5455/njppp.2023.13.12564202329122023

Web Style

Mukherjee S, Sarkar A, Mishra S. Comparative evaluation of slit-skin smear with punch biopsy for diagnosing leprosy in suspected patient attending a tertiary care hospital in peripheral West Bengal. https://www.njppp.com/?mno=181127 [Access: April 17, 2025]. doi:10.5455/njppp.2023.13.12564202329122023

AMA (American Medical Association) Style

Mukherjee S, Sarkar A, Mishra S. Comparative evaluation of slit-skin smear with punch biopsy for diagnosing leprosy in suspected patient attending a tertiary care hospital in peripheral West Bengal. Natl J Physiol Pharm Pharmacol. 2024; 14(7): 1281-1284. doi:10.5455/njppp.2023.13.12564202329122023

Vancouver/ICMJE Style

Mukherjee S, Sarkar A, Mishra S. Comparative evaluation of slit-skin smear with punch biopsy for diagnosing leprosy in suspected patient attending a tertiary care hospital in peripheral West Bengal. Natl J Physiol Pharm Pharmacol. (2024), [cited April 17, 2025]; 14(7): 1281-1284. doi:10.5455/njppp.2023.13.12564202329122023

Harvard Style

Mukherjee, S., Sarkar, . A. & Mishra, . S. (2024) Comparative evaluation of slit-skin smear with punch biopsy for diagnosing leprosy in suspected patient attending a tertiary care hospital in peripheral West Bengal. Natl J Physiol Pharm Pharmacol, 14 (7), 1281-1284. doi:10.5455/njppp.2023.13.12564202329122023

Turabian Style

Mukherjee, Shuvankar, Arijit Sarkar, and Suchitra Mishra. 2024. Comparative evaluation of slit-skin smear with punch biopsy for diagnosing leprosy in suspected patient attending a tertiary care hospital in peripheral West Bengal. National Journal of Physiology, Pharmacy and Pharmacology, 14 (7), 1281-1284. doi:10.5455/njppp.2023.13.12564202329122023

Chicago Style

Mukherjee, Shuvankar, Arijit Sarkar, and Suchitra Mishra. "Comparative evaluation of slit-skin smear with punch biopsy for diagnosing leprosy in suspected patient attending a tertiary care hospital in peripheral West Bengal." National Journal of Physiology, Pharmacy and Pharmacology 14 (2024), 1281-1284. doi:10.5455/njppp.2023.13.12564202329122023

MLA (The Modern Language Association) Style

Mukherjee, Shuvankar, Arijit Sarkar, and Suchitra Mishra. "Comparative evaluation of slit-skin smear with punch biopsy for diagnosing leprosy in suspected patient attending a tertiary care hospital in peripheral West Bengal." National Journal of Physiology, Pharmacy and Pharmacology 14.7 (2024), 1281-1284. Print. doi:10.5455/njppp.2023.13.12564202329122023

APA (American Psychological Association) Style

Mukherjee, S., Sarkar, . A. & Mishra, . S. (2024) Comparative evaluation of slit-skin smear with punch biopsy for diagnosing leprosy in suspected patient attending a tertiary care hospital in peripheral West Bengal. National Journal of Physiology, Pharmacy and Pharmacology, 14 (7), 1281-1284. doi:10.5455/njppp.2023.13.12564202329122023

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