Response to clinical, neurophysiological and histopathological profile of patients with neuropathic pain secondary to leprosy from a referral service in southeastern Brazil

We read with great interest article entitled "Clinical, neurophysiological and histopathological profile of patients with neuropathic pain secondary to leprosy from a referral service in southeastern Brazil", where the authors have made an attempt to correlate clinical, neurophysiological, histopathological aspects, pain score and quality of life, etc. of neuropathic pain (NP) in patients with leprosy. 1 However, inappropriate design, faulty classification of the disease and selective interpretation of the results in the study has raised some important issues:(1) The study has been mentioned as 'prospective, observational, cross-sectional and descriptive' -an observational study can either be cross-sectional or be prospective.As no follow-up information is included, the study design remains cross-sectional.(2) The study includes referred patients with pure neural form of leprosy (PNL), but the authors have classified them into pauci and multibacillay (PB/MB) types.WHO guidelines on leprosy control clearly state that even a single nerve involvement in leprosy is MB disease and hence all patients should have been classified and treated as MB disease. 2 (3) Both type 1 and type 2 reactions were seen in 66.6% of the patients (33.3% of each type), how this diagnosis about the type of reaction in the nerve was arrived at remains unclear.(4) Furthermore, '55.6% presented with altered dermatological examination'; what is the basis of this statement, given the fact that all cases were described as PNL, which are supposed to have no cutaneous lesions.