02312nas a2200241   4500000000100000008004100001260001200042100001300054700001200067700001200079700001200091700001500103700001200118700001500130700001300145700001200158700001300170700001300183700001200196245013300208520171500341022001402056       2020                            d  c04/20201 aShukla B1 aVerma R1 aKumar V1 aKumar M1 aMalhotra K1 aGarg RK1 aMalhotra H1 aSharma P1 aKumar N1 aUniyal R1 aPandey S1 aRizvi I00aPathological, ultrasonographic and electrophysiological characterization of clinically diagnosed cases of pure neuritic leprosy.3 a<p>A subset of neuritic form of leprosy, called pure neuritic leprosy (PNL), seen in a minority of leprosy patients, is characterized by peripheral neuropathy without skin lesions and an absence of acid-fast bacilli on skin smears. Patients with PNL are often started on drug therapy without confirmation of diagnosis. We, therefore, did a prospective study of clinically diagnosed pure neuritic leprosy patients with correlation of ultrasonographic and biopsy findings. A total of 100 consecutive patients with PNL, diagnosed according to the consensus case definition, were included in the study. All patients underwent nerve conduction study, peripheral nerve ultrasonography, and sural nerve biopsy. Multiple mononeuropathies were present in 75% of cases, mononeuropathy in 18%, and polyneuropathy in the remaining 7%. Compared to clinical examination, ultrasonographic assessment of the peripheral nerves was not only better at the detection of thickening but also helped in characterization of their fascicular architecture, echogenicity, and vascularity. A total of 32 cases were confirmed on nerve biopsy, out of which 75% had demonstrable lepra bacilli. Cranial nerve involvement, presence of trophic ulcers, and bilateral thickening of the great auricular nerve were significantly associated with the positivity of lepra bacilli. A significant improvement in the disability score happened after multidrug therapy. A comprehensive electrophysiologic, ultrasonographic, and histological evaluation may be helpful in establishing a diagnosis of pure neuritic leprosy with greater confidence, while ruling out other non- leprosy diagnoses. This article is protected by copyright. All rights reserved.</p>  a1529-8027