Question

A 38-year-old patient with hypopigmented nodular lesions with anesthesia overarm with ulnar nerve involvement underwent a biopsy and intradermal antigen test. Based on the image, which statement regarding the condition is most accurate? 

• A. Tuberculoid leprosy with a positive antigen test
• B. Lepromatous leprosy with a positive antigen test
• C. Erythema nodosum leprosum with a negative antigen test
• D. Lepromatous leprosy with a negative antigen test

Hint:

In cases of lepromatous leprosy, look for nerve involvement and skin lesions. A negative antigen test helps distinguish this from other types of leprosy.

Answer 1

The Correct Option is D

The clinical presentation described involves a 38-year-old patient with hypopigmented nodular lesions, anesthesia over the arm, and ulnar nerve involvement, suggesting a type of leprosy. The biopsy and intradermal antigen test results are crucial for diagnosis.

Leprosy, caused by Mycobacterium leprae, manifests in two polar forms: tuberculoid and lepromatous leprosy, with a spectrum in between. The key points about the antigen test, known as the lepromin test, include:

• Tuberculoid leprosy: Strong immune response with granuloma formation; typically positive lepromin test.
• Lepromatous leprosy: Poor immune response with widespread infection; typically negative lepromin test.

In this case, the lepromatous leprosy option aligns correctly because it matches the symptoms described (nodular lesions and ulnar nerve involvement) and a negative antigen test, which is consistent with the weak cellular immune response typically seen in lepromatous leprosy.

The correct answer is indeed Lepromatous leprosy with a negative antigen test, fitting both clinical and diagnostic features described.