Three cases of pure neuritic (PN) leprosy at detection in which skin lesions became visible during their course.

Abstract

Pure neuritic leprosy (PN leprosy) is a type of leprosy with nerve involvement, but without obvious skin lesions. It is not uncommon in the south of Bangladesh, but its nature is less recognized than that in other types of leprosy. Male is dominant on its occurrence with higher disability grading. The histopathological study shows that the entire spectrum can be observed in nerves of PN leprosy. There was no relation among clinical parameters, such as the number and distribution of affected nerves, the immune response and its histopathology. Therefore the treatment of PN leprosy is not well-established at field level. Out of 1,741 newly detected cases by Dhanjuri Leprosy Project--Khulna Branch (PIME Sisters) in Khulna, the south of Bangladesh from 1994 to 1998, 141, or 8.10% were diagnosed as PN leprosy. 6 cases out of 1,741, or 0.34% were canceled afterwards because of wrong diagnosis, of which one misdiagnosed as PN leprosy. Three cases out of 140 of primary neuritic leprosy proved to have obvious skin lesions some time after their treatment started. The details of the three cases are described in this paper.