01692nas a2200205   4500000000100000008004100001653002700042653001900069653001200088653002500100653003400125653002500159100001400184700001400198245011600212856005100328300001400379490000700393520108600400       2018                            d10aCutaneous nerve biopsy10aHistopathology10aleprosy10aMycobacterium leprae10aPure Neural leprosy diagnosis10aSkin overlying nerve1 aShetty VP1 aWakade AV00aDiagnostic value of histopathology of the affected nerve versus overlying skin, in pure neural cases of leprosy  uhttps://leprosyreview.org/article/89/2/16-5169  a165–1690 v893 a<p><strong>Summary</strong> Proof of leprosy as a cause of ‘pure neural leprosy’ needs histological evidence, which is often sought in the affected peripheral nerves. Obtaining a nerve biopsy may not always be practicable. Thus in this study, the histopathology of the involved nerve and the overlying skin were compared in 32 cases of ‘pure neural leprosy’ in order to determine the utility of skin biopsy in diagnosing leprosy. Evidence of leprosy was present in all, except one nerve biopsy (97%) and in 14/32 (44%) skin biopsies from skin overlying the biopsied nerve. One noteworthy finding is that in nerves showing BL-LLs leprosy, which formed a major group (59%), only 26% of biopsies of the overlying skin showed evidence of leprosy. In nerves showing BT pathology, 67% of the biopsies of overlying skin showed evidence of leprosy.<br />
<strong>Conclusion:</strong> Histopathological examination of the overlying skin compares poorly with the affected cutaneous nerve and is of limited diagnostic value, particularly at the lepromatous end of the spectrum.</p>