Leprosy: lepromatous histology: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Leprosy: lepromatous histology

Sample item

A skin biopsy from a patient with symmetric nodules shows sheets of foamy macrophages filled with acid-fast bacilli in globi, separated from the epidermis by a clear zone. What is this zone called?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Grenz zone

Lepromatous leprosy shows Virchow (foam) cells packed with bacilli and a subepidermal band of uninvolved collagen, the grenz zone. Tuberculoid leprosy, in contrast, has epithelioid granulomas that may reach the epidermis.

Option by option

  • A. Zone of Langhans

    Langhans cells are giant cells in granulomas, not a zone.

  • B. Grenz zone (correct)

    Correct. A grenz zone separates the infiltrate from the epidermis in LL.

  • C. Palisade zone

    Palisading refers to nuclei lined at the periphery, as in basal cell carcinoma.

  • D. Max-Joseph space

    Max-Joseph spaces are clefts in lichen planus.

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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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is B, Grenz zone. Lepromatous leprosy shows Virchow (foam) cells packed with bacilli and a subepidermal band of uninvolved collagen, the grenz zone.

Why is "Zone of Langhans" not the answer?

Langhans cells are giant cells in granulomas, not a zone.

Why is "Palisade zone" not the answer?

Palisading refers to nuclei lined at the periphery, as in basal cell carcinoma.

Why is "Max-Joseph space" not the answer?

Max-Joseph spaces are clefts in lichen planus.

What concept does this question test?

It tests Leprosy: lepromatous histology in Dermatology. Tuberculoid leprosy, in contrast, has epithelioid granulomas that may reach the epidermis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Leprosy: lepromatous histology?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.