Clinical profile of patients with pure neuritic leprosy: 20 years’ experience at a tertiary referral centre from North India

Introduction Pure neuritic leprosy (PNL) is characterized by enlargement of peripheral nerves, sensory loss without any cutaneous lesions, skin slit smear negativity and a variable lepromin test and histopathology. Methods This was a retrospective analysis of the clinical records of all the leprosy patients enrolled in the Leprosy Clinic, during the years 1999–2019. The patient records fulfilling the diagnostic criteria of PNL were considered for analysis. Results A total of 1225 patients registered leprosy cases, out of which 41 (3.3%) patients were diagnosed with PNL. Mean age was 31 years and 80% patients were male. Multiple nerves were affected in 25 (61%) patients and one nerve was found to be affected in only 16 (39%) patients. Grade 2 deformities were seen in 26 (63%) patients. All patients were treated with multi-drug therapy 25 patients received the multibacillary regimen and 16 received the paucibacillary regimen; 27 (66%) patients completed the treatment as prescribed. Conclusion Leprosy is the most common treatable cause of peripheral neuropathy. Therefore, early detection of leprosy neuropathy is important for preventing deformities and disabilities. It may be advisable to treat all PNL cases with the multibacillary multidrug therapy in view of higher rate of deformities.