A 45 year old male had multiple hypoaesthetic mildly erythematous large plaques with elevated margins on trunk and extremities. His ulnar and lateral popliteal nerves on both sides were enlarged . The most probable diagnosis is:

**Core Concept**
The patient's symptoms suggest a chronic inflammatory demyelinating polyneuropathy with skin involvement, pointing towards a systemic autoimmune disorder.

**Why the Correct Answer is Right**
The patient's presentation of hypoaesthetic mildly erythematous large plaques with elevated margins on trunk and extremities, along with enlarged ulnar and lateral popliteal nerves, is suggestive of **Necrobiosis Lipoidica**. This condition is characterized by a combination of skin lesions and neuropathy, often associated with diabetes mellitus or autoimmune disorders. The skin lesions result from inflammation and damage to blood vessels, which can lead to necrosis and scarring.

**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not provided.
* **Option B:** While this option might be related to a similar clinical presentation, it is not the most probable diagnosis based on the information given.
* **Option C:** This option is a type of neuropathy, but it does not fully explain the skin involvement and systemic symptoms described in the patient's presentation.
* **Option D:** This option is not relevant to the patient's symptoms and is not a systemic autoimmune disorder with skin involvement.

**Clinical Pearl / High-Yield Fact**
Necrobiosis lipoidica is often associated with diabetes mellitus, and patients with this condition may also have other systemic manifestations such as neuropathy and vasculitis.

**Correct Answer:** D.

✓ Correct Answer: D. Borderline lepromatous leprosy