Peripheral nerve thickening: leprosy

Case contributed by Dr Maulik S Patel


Taking treatment for leprosy for the last few months. The nerve biopsy was not done. Complaining of the right-hand dorsum painful cord-like structures.

Patient Data

Age: 30 years
Gender: Male

The ulnar nerve shows enlargement from the proximal arm to the distal forearm. The nerve shows maximum cross-sectional in the mid-distal arm region. There is a thickening of its dorsal cutaneous branch and its divisions to 3rd, 4th, 5th digits. There is no neural/ perineural mass lesion. The nerve around the ulnar tunnel is normal.

There is a thickening of the superficial sensory branch of the radial nerve from the distal forearm level. The dorsal divisions of the nerve also show thickening.

The median nerve is normal.

There is an enlarged, ovoid, non-necrotic lymph node at the medial
supracondylar region of the arm. It shows preserved hilar fat.

Skin changes involving the dorsum of the hand over the 2nd, 3rd, 5th MCP joint region, and extending to the middle and the little fingers.

Case Discussion

The case shows upper limb peripheral nerves thickening in a patient under treatment for the leprosy.

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