Abstract
Leprosy is caused by Mycobacterium leprae bacillus and despite recommendation of multidrug therapy by World Health Organisation in 1981 and eradication programme in various countries; disease prevails and new cases added annually. Variable clinical presentation ranges from limited tuberculoid to widespread lepromatous leprosy. The neuritic presentation varies from mononeuropathy to mononeuropathy multiplex. The disease commonly affects the ulnar, radial in upper and common peroneal, posterior tibial in lower extremity. The neuritic leprosy is easily suspected when there is hypoanesthetic skin lesion with thickened and tender nerve. Involvement of uncommon nerve and pure neuritic presentation, a rare form of leprosy in which skin is spared often leads to diagnostic challenge. Biopsy is not needed to initiate treatment but sometimes required to rule our other diseases. We report a rare case of isolated thickening of greater auricular nerve and diagnostic dilemma encountered in the era of evidence-based medicine.
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