Dermatology · Leprosy and Cutaneous Tuberculosis

A 35-year-old man from a leprosy-endemic area presents with a single hypopigmented macule with loss of sensation and a single thickened nerve. Slit-skin smear is negative. The WHO classification for treatment purposes is:

  • A Paucibacillary — 6 months MB-MDT
  • B Multibacillary — 12 months MB-MDT
  • C Indeterminate leprosy — single-dose ROM therapy
  • D Paucibacillary — 6 months PB-MDT (rifampicin + dapsone)
Correct answer: D. Paucibacillary — 6 months PB-MDT (rifampicin + dapsone)

Explanation

WHO classifies leprosy for treatment as paucibacillary (PB: 1-5 patches) or multibacillary (MB: >5 patches). This patient has a single macule = PB. PB-MDT consists of rifampicin 600 mg once monthly (supervised) and dapsone 100 mg daily for 6 months. Single-dose ROM (rifampicin + ofloxacin + minocycline) is specifically for single-lesion PB leprosy without nerve thickening. This patient has a thickened nerve (nerve involvement), so full 6-month PB-MDT is appropriate, not single-dose ROM. MB-MDT (rifampicin + dapsone + clofazimine) for 12 months is for MB disease (>5 lesions or SSS positive).

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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