Diagnosis of erythema nodosum leprosum (type 2 reaction) by cytology.

OBJECTIVE: It was the aim of this study to evaluate the possible role of cytology in erythema nodosum leprosum (ENL) and its use for early treatment of the disease.

STUDY DESIGN: We present a prospective study conducted with 15 clinically diagnosed ENL cases. Among them, 13 cases had previously been diagnosed with lepromatous leprosy (LL) and 2 patients were new LL cases with signs and symptoms of ENL lesions. Haematoxylin and eosin stain with modified Ziehl-Neelsen stain was performed on fine needle aspiration material. One case was sent for biopsy.

RESULTS: Complete cytological diagnosis of ENL was done in all 15 cases. Histopathological study revealed classical ENL lesions which also showed ENL features in cytodiagnosis.

CONCLUSION: In the past, the accurate mode of diagnosis of ENL lesions was histopathology. However, clinicians have to wait a long time for the report and generally they start treatment only on the basis of clinical signs and symptoms. Cytodiagnosis of ENL lesions is an early, effective method for accurate diagnosis and helps to initiate treatment for these painful lesions.