A retrospective review of leprosy diagnosed histopathologically from skin biopsy specimens in central South…

Cohort studySouthern African journal of infectious diseases· 2026

A retrospective review of leprosy diagnosed histopathologically from skin biopsy specimens in central South Africa.

Ruben B van Wyk, Danita L le Grange, Liska Budding

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DermatopathologyCohort studyDiagnosis

Most South African leprosy cases on biopsy were the multibacillary, advanced form.

A retrospective review of leprosy diagnosed histopathologically from skin biopsy specimens in central South Africa.

Ruben B van Wyk … Liska Budding

Southern African journal of infectious diseases · 2026

Background

Leprosy, caused by Mycobacterium leprae , remains a condition designated by the World Health Organization (World Health Organization) as a neglected tropical disease, despite formal eradication in South Africa.

Purpose

The study aimed to describe the histopathological spectrum and clinical features of leprosy diagnosed on skin biopsies over a 10-year period in central South Africa.

Methods

A retrospective review was performed of histologically confirmed leprosy cases diagnosed from January 2015 to December 2024.

Results

62%

most cases were the advanced, more severe multibacillary form

More results

Most resided in the Mangaung Metropolitan area, with additional cases dispersed across the Free State and Northern Cape provinces.

Punch biopsies predominated, most commonly obtained from the head and/or neck and the upper limbs.

More results

Ridley-Jopling (Ridley-Jopling) subtypes were mostly lepromatous leprosy (38%), while 23% of cases were indeterminate.

Repeat biopsies revealed treatment response or persistent disease.

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Conclusion · 1 of 3

Leprosy persists as a sporadic but geographically widespread disease in central South Africa, often presenting in advanced multibacillary forms. Histopathology remains essential for diagnosis and subtyping.

Conclusion · 2 of 3

Strengthening clinician awareness, biopsy protocols, and treatment continuity is critical to achieving the goal of zero leprosy of the World Health Organization.

Conclusion · 3 of 3

CONTRIBUTION: The findings confirm that, although rare, leprosy still prevails in central South Africa.

A retrospective review of leprosy diagnosed histopathologically from skin biopsy specimens in central South Africa.

A retrospective review of leprosy diagnosed histopathologically from skin biopsy specimens in central South Africa.

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