Leprosy: relapse versus reaction: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Leprosy: relapse versus reaction

Sample item

Three years after completing 12 months of multibacillary therapy, a man develops a few new skin lesions that appeared slowly, without redness, pain or nerve tenderness. The bacteriological index, 1+ at release, is now 3+ with many solid-staining bacilli. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Relapse

A relapse is insidious with new, non-inflamed lesions and a rising bacteriological index with viable bacilli after treatment is completed. Reactions are inflammatory and painful, with a falling or stable index, and they typically occur during treatment or in the first years after it.

Option by option

  • A. Erythema nodosum leprosum

    ENL presents with tender crops of nodules, fever and systemic upset.

  • B. Lucio phenomenon

    Lucio phenomenon is a necrotising reaction of untreated diffuse lepromatous disease.

  • C. Type 1 lepra reaction

    A type 1 reaction is acutely inflamed and painful with nerve tenderness, and the index does not rise.

  • D. Relapse (correct)

    Correct. Slow, non-inflammatory new lesions with a rising index and viable bacilli indicate relapse.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Dermatology questions

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is D, Relapse. A relapse is insidious with new, non-inflamed lesions and a rising bacteriological index with viable bacilli after treatment is completed.

Why is "Erythema nodosum leprosum" not the answer?

ENL presents with tender crops of nodules, fever and systemic upset.

Why is "Lucio phenomenon" not the answer?

Lucio phenomenon is a necrotising reaction of untreated diffuse lepromatous disease.

Why is "Type 1 lepra reaction" not the answer?

A type 1 reaction is acutely inflamed and painful with nerve tenderness, and the index does not rise.

What concept does this question test?

It tests Leprosy: relapse versus reaction in Dermatology. Reactions are inflammatory and painful, with a falling or stable index, and they typically occur during treatment or in the first years after it.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Leprosy: relapse versus reaction?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.