Primary Neural Leprosy

Abstract

Leprosy is a multisystemic disease that mainly affects tissues originating from the embryonic ectoderm: skin and peripheral nerves. It is diagnosed by the presence of skin lesions accompanied by loss of sensation, positive skin smear, and enlarged nerves. However, in leprosy patients without skin lesions, with nerve lesions only, the diagnosis is often missed if not suspected. This leprosy presentation is denominated primary neural leprosy, pure neural leprosy, or neuritic leprosy. With no skin signs at all, neurological investigations define the picture of mononeuropathies, multiple mononeuropathies, or polyneuropathies. The main causes of these neuropathies are entrapments, metabolic, traumatic, hereditary, infectious, and nerve tumors. The histopathology of neural involvement and its clinical findings are presented.