Latar belakang: Pure-Neural-Leprosy (PNL) merupakan bentuk klinis kusta yang jarang ditemui,  ditandai dengan penebalan saraf tepi tanpa lesi kulit, hilangnya fungsi sensoris dengan atau tanpa paralisis motoris dan reaksi kusta. Pure-Neural-Leprosy  (PNL) sulit didiagnosis  karena tidak ada lesi khas kusta dan bakteri tahan asam (BTA) pada apusan kulit.
Kasus: Seorang wanita didiagnosis PNL dengan neuritis dan kecacatan derajat 2. Pasien mempunyai riwayat parestesi, kekakuan dan luka tak nyeri pada ekstremitas. Pada pemeriksaan fisis tidak ditemukan lesi kulit, tetapi didapatkan anestesi pada ekstremitas, pembesaran saraf ulnaris dan suralis, atrofi tenar, hipotenar serta claw hand tangan kiri, dan ulkus ibu jari kaki kanan. Pada apusan kulit tidak ditemukan BTA. Biopsi saraf suralis menunjukkan gambaran kusta tipe borderline dengan BTA. Pasien mendapat rejimen Pausibasiler (PB) WHO.
Diskusi: Diagnosis PNL dapat ditegakkan berdasarkan disfungsi klinis saraf. Pemeriksaan baku adalah biopsi saraf yang sulit dilakukan dan berisiko tinggi. Pada kasus ini, diagnosis pasti PNL ditegakkan berdasarkan hasil biopsi saraf. Belum ada acuan baku terapi PNL. Pasien mendapat terapi rejimen PB WHO berdasarkan The National Leprosy Eradication Programme.
Kesimpulan: Pure-Neural-Leprpasieny (PNL) perlu dipertimbangkan jika ditemukan gangguan fungsi saraf tepi sensoris dan motoris tanpa lesi kulit dan BTA pada apusan kulit untuk mencegah disability.

Kata kunci: pure-neural-leprosy, disability, terapi

Background: Pure-Neural-Leprpasieny (PNL) is a rare variant of leprosy with thickening of peripheral nerve without skin lesion, sensibility impairment, with or without motor paralysis and nerve reaction. PNL is difficult to diagnose because of no typical skin lesion and acid-fast-bacilli (AFB) on slit-skin-smear (SSS).  
Case: A women was diagnose PNL with neuritis and deformity grade 2. She had history of paresthesia, stiffness, and painless wound on extremities. There were no skin lesions, but anesthesia on extremities, ulnaris and suralis nerves enlargement, thenar, hypothenar athrophy and claw hand on left hand, and toe tumb ulcer were found. SSS showed no AFB. Suralis nerve biopsy revealed borderline leprosy with AFB. She received Pausibasiler WHO regiment.
Discussion: Pure-Neural-Leprpasieny (PNL) could be diagnosed based on clinical nerve dysfunction. The gold standard examination is nerve biopsy which is difficult and risky. In this case definite diagnosis was established based on nerve biopsy result. There is no standart treatment for PNL. She received Pausibasiler regiment based on The National Leprpasieny Eradication Programme.
Conclusion: Pure-Neural-Leprpasieny (PNL) have to be considered if there is sensory and motor peripheral nerve function impairment without skin lesion and AFB on SSS in order to prevent disability.

Keyword: pure-neural-leprpasieny, disability, treatment