Leprosy: pure neuritic leprosy with absent skin lesions: 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: pure neuritic leprosy with absent skin lesions

Sample item

A farmer has an enlarged, tender ulnar nerve and a patch of anaesthesia on the hypothenar eminence, but no skin lesion and a negative skin smear. Which test most directly supports the diagnosis in this situation?

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

The answer and the reasoning

C. Nerve biopsy or fine-needle aspiration from the involved nerve

In pure neuritic leprosy skin smears are usually negative, so a sample from the affected nerve showing granulomas or acid-fast bacilli supports the diagnosis. Ultrasonography of nerves is also helpful.

Option by option

  • A. Serum ANA

    ANA testing screens for connective tissue disease and does not diagnose leprosy.

  • B. Repeat slit-skin smear from earlobes

    Earlobe smears are typically negative when skin is uninvolved.

  • C. Nerve biopsy or fine-needle aspiration from the involved nerve (correct)

    Correct. Sampling the involved nerve provides tissue confirmation.

  • D. Lepromin test

    Lepromin indicates immune status and is not diagnostic.

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 C, Nerve biopsy or fine-needle aspiration from the involved nerve. In pure neuritic leprosy skin smears are usually negative, so a sample from the affected nerve showing granulomas or acid-fast bacilli supports the diagnosis.

Why is "Serum ANA" not the answer?

ANA testing screens for connective tissue disease and does not diagnose leprosy.

Why is "Repeat slit-skin smear from earlobes" not the answer?

Earlobe smears are typically negative when skin is uninvolved.

Why is "Lepromin test" not the answer?

Lepromin indicates immune status and is not diagnostic.

What concept does this question test?

It tests Leprosy: pure neuritic leprosy with absent skin lesions in Dermatology. Ultrasonography of nerves is also helpful.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: pure neuritic leprosy with absent skin lesions?

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.