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 PNL 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 PNL with greater confidence, while ruling out other non‐leprosy diagnoses.

中文翻译：

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临床诊断的纯神经性麻风病病例的病理，超声和电生理学特征。

在少数麻风患者中见到的一种麻风神经病麻风亚种，称为纯神经麻风病（PNL），其特征是周围神经病变，没有皮肤病变，皮肤涂片上没有耐酸杆菌。PNL患者通常在未确诊的情况下开始接受药物治疗。因此，我们对临床诊断为PNL的患者进行了前瞻性研究，这些患者与超声检查和活检结果相关。根据共识病例定义诊断的总共100例PNL连续患者被纳入研究。所有患者均接受了神经传导研究，周围神经超声检查和腓肠神经活检。75％的患者存在多种单神经病，18％的患者患有单神经病，其余7％的患者存在多发性神经病。与临床检查相比 超声检查对周围神经的影响不仅在发现增厚方面更好，而且还有助于表征其束状结构，回声性和血管性。共有32例经神经活检确诊，其中75％具有明显的麻风杆菌。颅神经受累，营养性溃疡的存在和耳大神经的双侧增厚与麻风杆菌的阳性呈显着相关。多药治疗后，残疾评分显着改善。进行全面的电生理，超声检查和组织学评估可能有助于建立更高可信度的PNL诊断，同时排除其他非麻风病诊断。