Abstract

Introduction: Pure neuritic leprosy is characterized by sensory and motor changes in leprosy in the absence of acid fast lepra bacilli on histopathology.

Objectives: To understand the neurological complications of leprosy which can occur due to the lack of complete & proper treatment & the clinical and histological features of patient with pure neuritic leprosy.

Methods: Here we will discuss a case report of a 23 year old male patient who presented with complaints of decreased sensation, weakness and thinning of right hand gradually over a period of 10 years.

History of multibacillary leprosy before 10 years with irregular treatment.

On dermatological examination, there was generalized xerosis noted over the dorsum of right hand & forearm with finely scaly, ichthyosis like skin changes.

On neurological examination, there was decreased sensation over the dorsum of right hand along with motor deficits. Thickening of ulnar nerve present on palpation.

Results: Patient was advised high resolution ultrasound examination of both upper limbs which revealed thickening of ulnar nerve present over both upper limbs.

Skin biopsy was done & histopathology reveals perivascular inflammatory infiltrate in the dermal vessels, dermal fibrosis & thickening.

Conclusion: Even though leprosy was previously eliminated many years ago in India, there has been a drastic increase recently in the reporting of incidence of new cases of leprosy and cases with residual deformities due to leprosy.

Hence, it is very important on the part of clinicians & health care workers to strictly monitor the treatment & follow up of the patient in order to prevent deformities.

Keywords: Leprosy, Acid fast bacilli, pure neuritic leprosy.

Key Messages: In order to prevent the serious complications that can occur due to leprosy, it is important to know the steps in the management of leprosy, which will ease the diagnosis & facilitate quick intervention.