title: Evaluation of agreement between clinical and histopathological data for classifying leprosy.
abstract: BACKGROUND
  The diversity of clinical manifestations of leprosy has given rise to different classification systems. However, there are important differences in the sensitivity and specificity of these classifications. The objective of this study was to evaluate the agreement between clinical and histopathological data for classifying leprosy.
  
  
  METHODS
  A total of 1265 patient reports containing clinical and histopathological data relating to the diagnosis and classification of leprosy were included in this study. The diagnostic concordance between the clinical form (Madrid classification) and the histopathological type, as well as the initial and final classifications, was calculated by dividing the number of concordant cases by the total number of patients.
  
  
  RESULTS
  The overall agreement between the World Health Organization operational classification and the results of direct smear examination of the lesion for acid-fast bacilli was 84.8% (1073/1265). The clinical-histopathological agreement was 58.1% (735/1265). The indeterminate and lepromatous forms were those that showed the highest percentages of agreement: 72.1% (186/258) and 71.0% (142/200), respectively.
  
  
  CONCLUSIONS
  Although classifications based on clinical characteristics have an important role in the control of leprosy, they present flaws that can influence the adequacy of treatment. Therefore, a histopathological examination is important for appropriate treatment.
authors.affiliation: Postgraduate Program in Parasitic Biology, Department of Morphology, Universidade Federal de Sergipe, Avenida Marechal Rondon s/n, Jardim Rosa Elze, 49100-000 São Cristóvão, Sergipe, Brazil. santosvictor19@gmail.com
authors.forename: Victor Santana
authors.initials: VS
authors.lastname: Santos
authors.forename: Pedro Teles
authors.initials: PT
authors.lastname: de Mendonça Neto
authors.forename: Oscar Felipe
authors.initials: OF
authors.lastname: Falcão Raposo
authors.forename: Ricardo
authors.initials: R
authors.lastname: Fakhouri
authors.forename: Francisco Prado
authors.initials: FP
authors.lastname: Reis
authors.forename: Vera Lúcia Corrêa
authors.initials: VL
authors.lastname: Feitosa
mesh_terms: D001706:Biopsy; D005260:Female; D006801:Humans; D007918:Leprosy / Q000145:classification* / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008853:Microscopy / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012867:Skin / Q000473:pathology*; D014944:World Health Organization