Histopathology of tuberculoid (TT) leprosy demonstrates which specific combination that distinguishes it from other granulomatous dermatoses?

• A Foamy macrophages with no granuloma, AFB ++++
• B Epithelioid granulomas with subepidermal clear zone; no AFB
• C Well-formed epithelioid granulomas eroding the basal layer (subepidermal clear zone absent); no AFB ✓
• D Non-caseating granuloma with asteroid bodies and Schaumann bodies

Explanation

In tuberculoid leprosy, there is strong CMI leading to well-formed epithelioid cell granulomas that extend to the epidermis — the subepidermal clear zone (Grenz zone) is absent, a key distinguishing feature from lepromatous leprosy. AFB are absent or very few in TT. In lepromatous leprosy: foamy macrophages (Virchow cells), prominent Grenz zone, AFB abundant (globi). Asteroid/Schaumann bodies are features of sarcoidosis.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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