02184nas a2200241   4500000000100000008004100001260004700042653001300089653002300102653001700125653002700142653002600169100001400195700001600209700001800225700001800243700001200261700001400273245011500287856007900402490000700481520145400488       2025                            d  bInternational Medical Case Reports Journal10aChildren10aGrade 2 disability10aNerve biopsy10aNerve conduction study10aPure neuritic leprosy1 aGunawan H1 aRuchiatan K1 aPuspitosari D1 aHindritiani R1 aUsman H1 aWidjaja S00aPure Neuritic Leprosy In Children With Grade 2 Disability On Hands And Feet: A Rare Case And Literature Review  uhttps://www.tandfonline.com/doi/epdf/10.2147/IMCRJ.S497894?needAccess=true0 v183 a<p>Pure neuritic leprosy (PNL) is a rare clinical variant of leprosy, especially in children. This variant of leprosy only involves peripheral nerves without skin involvement or acid-fast bacilli (AFB) found on slit-skin smear examination. The challenging diagnosis and establishment of PNL due to the absence of skin lesions often lead to disability. A case of PNL with grade 2 disability of hands and feet in a 16-year-old boy was reported. The patient has been living in a leprosy-endemic area and has a history of contact with people who have symptoms of leprosy. On physical examination, there were finger contractures on both hands and feet, accompanied by bilateral ulnar, common peroneal, and posterior tibial nerve enlargement without any skin lesions. No AFB was found on the slit-skin smear examination. The diagnosis of PNL was established by the mononeuritis multiplex detected on the nerve conduction examination and the histopathological examine from the biopsy of the left ulnar nerve, which showed lymphocyte infiltration. The patient was treated with multidrug therapy for multibacillary leprosy and consulted with the Department of Physical Medicine and Rehabilitation and the Department of Orthopaedics and Traumatology for contracture management. Clinicians need to be aware of the signs and symptoms of PNL in order to avoid delays in diagnosis and treatment, as the diagnosis and establishment of PNL remain challenging.</p>