Diagnosis and Therapeutic Outcomes of Biopsy-Confirmed Pure Neuritic Leprosy: A Two-Decade Experience.

Background:Pure neuritic leprosy (PNL) is a distinct form of leprosy characterized by peripheral nerve involvement without skin lesions. Diagnosis is often delayed, and ‘silent neuritis’ contributes to progressive and irreversible nerve damage. Despite appropriate therapy, many patients develop long-term disability. This study describes the clinical profile, diagnostic patterns, therapeutic outcomes, and predictors of disability in biopsy-confirmed PNL. Methods:We conducted a retrospective observational cohort study at a tertiary referral centre in South India, enrolling biopsy-confirmed PNL cases from January 2003 to May 2023. Demographic, clinical, electrophysiological, and histopathological data were collected. The primary outcome was the proportion of patients with high disability at follow-up (WHO grade 2 or higher). Predictors of disability were identified using multivariable analysis.