title: Leprosy classification methods: a comparative study in a referral center in Brazil.
abstract: OBJECTIVE
  Different methods for the classification of leprosy have been proposed since the 1930s. The aim of this study was to compare the current methods at a referral center in Brazil.
  
  
  METHODS
  The World Health Organization (WHO) operational classification was compared to the Ridley and Jopling classification, the Madrid classification, and a classification based on the number of body areas affected by skin and/or neural lesions (NBAA). The correlation between the clinical and histopathological components of the Ridley and Jopling classification was assessed.
  
  
  RESULTS
  The agreement between the WHO operational classification and the Ridley and Jopling classification was 77.6% (kappa = 0.53). The WHO operational classification tended to overestimate the number of multibacillary patients. The WHO operational classification showed its best agreement with the NBAA. There was perfect agreement between the clinical and histopathological Ridley and Jopling classification in 46.9% of the patients.
  
  
  CONCLUSIONS
  The agreement between the WHO operational classification and the Ridley and Jopling classification was better than any other purely clinical classification, reinforcing the importance and simplicity of the operational method. Although major disagreement between the clinical and histopathological Ridley and Jopling classification was uncommon, perfect agreement occurred in less than half of the cases, and was even lower for the borderline lepromatous and tuberculoid forms. Possible reasons for the differences are discussed; these showed that there may be room for improvement in the Ridley and Jopling classification histopathological criteria.
authors.affiliation: Pathology Department, Universidade Federal de Minas Gerais, Campus da Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Bloco C3/251, 6627 Antônio Carlos Av, Pampulha, Belo Horizonte 31.270-010, Brazil.
authors.forename: Ismael Alves
authors.initials: IA
authors.lastname: Rodrigues Júnior
authors.affiliation: Pathology Department, Universidade Federal de Minas Gerais, Campus da Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Bloco C3/251, 6627 Antônio Carlos Av, Pampulha, Belo Horizonte 31.270-010, Brazil.
authors.forename: Letícia Trivellato
authors.initials: LT
authors.lastname: Gresta
authors.affiliation: Pathology Department, Universidade Federal de Minas Gerais, Campus da Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Bloco C3/251, 6627 Antônio Carlos Av, Pampulha, Belo Horizonte 31.270-010, Brazil.
authors.forename: Maria de Lourdes Meirelles
authors.initials: Mde L
authors.lastname: Noviello
authors.affiliation: Pathology Department, Universidade Federal de Minas Gerais, Campus da Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Bloco C3/251, 6627 Antônio Carlos Av, Pampulha, Belo Horizonte 31.270-010, Brazil.
authors.forename: Christiane Teixeira
authors.initials: CT
authors.lastname: Cartelle
authors.affiliation: Dermatology Department, Fundação Hospitalar do Estado de Minas Gerais, Hospital Eduardo de Menezes, Bonsucesso, Belo Horizonte, Brazil.
authors.forename: Sandra
authors.initials: S
authors.lastname: Lyon
authors.affiliation: Pathology Department, Universidade Federal de Minas Gerais, Campus da Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Bloco C3/251, 6627 Antônio Carlos Av, Pampulha, Belo Horizonte 31.270-010, Brazil. Electronic address: rosa@icb.ufmg.br.
authors.forename: Rosa Maria Esteves
authors.initials: RM
authors.lastname: Arantes
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D005260:Female; D006801:Humans; D007918:Leprosy / Q000145:classification* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012867:Skin / Q000473:pathology; D014944:World Health Organization
keywords: Leprosy classification; Operational classification; Ridley Jopling