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Dermatology · Leprosy: nerve abscess
Sample itemA patient with tuberculoid leprosy has a tender fluctuant swelling of the ulnar nerve with rapid loss of function. What is the next appropriate step?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Corticosteroids, and surgical decompression if no response
A nerve abscess is a complication of tuberculoid and borderline leprosy that threatens nerve function. Corticosteroids are tried first and surgical decompression of the nerve is done if there is no improvement or if the abscess is large.
Option by option
A. Increase dapsone dose
Dapsone dose escalation does not help.
B. Immediate nerve excision
Excision would cause permanent loss.
C. Observation only
Observation risks permanent paralysis.
D. Corticosteroids, and surgical decompression if no response (correct)
Correct. Steroids and decompression are used to save nerve function.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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