Single patch, mononeuritic multibacillary leprosy: A case report

Demonstration of lepra bacilli by means of slit skin smear (SSS) and skin histopathology is well recognised to substantiate the clinical classification of leprosy patients. Nerve biopsy, although not widely practiced, has been shown to be more specific in the diagnosis of leprosy. Discordance between nerve and skin histology is known, with involved nerves generally unfolding a higher bacterial load and a lower spectrum of the disease. Herein, we report a patient of borderline tuberculoid leprosy who after completing 6 months of paucibacillary regimen (PBR) of multi drug therapy (MDT), was found to house lepra bacilli only on nerve aspirate, thereby reclassifying the treatment regimen for his disease.