{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:19:52Z","timestamp":1785406792799,"version":"3.56.0"},"reference-count":30,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Leprosy, caused by\u00a0Mycobacterium leprae, remains a condition designated by the World Health Organization (WHO) as a neglected tropical disease, despite formal eradication in South Africa. Histopathology is pivotal in the diagnosis of leprosy, particularly in resource-limited settings.\nObjectives:\u00a0The 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.\nMethod:\u00a0A retrospective review was performed of histologically confirmed leprosy cases diagnosed from January 2015 to December 2024. Data were extracted from laboratory records and analysed descriptively.\nResults:\u00a0Twelve patients were included (mean age 43.9 years, range 25 years \u2013 64 years; male-to-female ratio 1.4:1). 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. World Health Organization classification identified 62% of cases as multibacillary (MB). Ridley-Jopling (RJ) subtypes were mostly lepromatous leprosy (38%), while 23% of cases were indeterminate. Repeat biopsies revealed treatment response or persistent disease. Comorbidities included HIV and tuberculosis.\nConclusion:\u00a0Leprosy persists as a sporadic but geographically widespread disease in central South Africa, often presenting in advanced MB forms. Histopathology remains essential for diagnosis and subtyping. Strengthening clinician awareness, biopsy protocols, and treatment continuity is critical to achieving the goal of zero leprosy of the WHO.\nContribution:\u00a0The findings confirm that, although rare, leprosy still prevails in central South Africa. Therefore, clinicians and anatomical pathologists should consider a diagnosis of leprosy in patients with atypical or non-resolving signs and symptoms.<\/jats:p>","DOI":"10.4102\/sajid.v41i1.802","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T09:42:48Z","timestamp":1781257368000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A retrospective review of leprosy diagnosed histopathologically from skin biopsy specimens in central South Africa"],"prefix":"10.4102","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5962-9194","authenticated-orcid":false,"given":"Ruben B.","family":"van Wyk","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/009xwd568","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Free State"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6394-0919","authenticated-orcid":false,"given":"Danita L.","family":"le Grange","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/009xwd568","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Free State"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4284-1866","authenticated-orcid":false,"given":"Liska","family":"Budding","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/009xwd568","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Free State"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Patel K, Patel PR, Vyas J, Bhagat VM. 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