Leprosy: tuberculoid histology: 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: tuberculoid histology

Sample item

Which histological finding best fits tuberculoid leprosy?

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

The answer and the reasoning

A. Epithelioid cell granulomas with Langhans giant cells and lymphocytes, with nerve destruction and scarce bacilli

Tuberculoid leprosy shows well-formed epithelioid granulomas surrounded by lymphocytes along dermal nerves, with few or no bacilli. There is no grenz zone as granulomas can abut the epidermis.

Option by option

  • A. Epithelioid cell granulomas with Langhans giant cells and lymphocytes, with nerve destruction and scarce bacilli (correct)

    Correct. Granulomas around nerves with scant bacilli define TT.

  • B. Sheets of foamy macrophages with globi

    Foamy macrophages with globi describe lepromatous disease.

  • C. Suprabasal acantholysis

    Suprabasal acantholysis is the pattern of pemphigus vulgaris.

  • D. Neutrophilic vasculitis with fibrinoid necrosis

    Neutrophilic vasculitis describes erythema nodosum leprosum or Lucio phenomenon.

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.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is A, Epithelioid cell granulomas with Langhans giant cells and lymphocytes, with nerve destruction and scarce bacilli. Tuberculoid leprosy shows well-formed epithelioid granulomas surrounded by lymphocytes along dermal nerves, with few or no bacilli.

Why is "Sheets of foamy macrophages with globi" not the answer?

Foamy macrophages with globi describe lepromatous disease.

Why is "Suprabasal acantholysis" not the answer?

Suprabasal acantholysis is the pattern of pemphigus vulgaris.

Why is "Neutrophilic vasculitis with fibrinoid necrosis" not the answer?

Neutrophilic vasculitis describes erythema nodosum leprosum or Lucio phenomenon.

What concept does this question test?

It tests Leprosy: tuberculoid histology in Dermatology. There is no grenz zone as granulomas can abut the epidermis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: tuberculoid histology?

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.