A case of recurrent rash and leg numbness mimicking systemic rheumatic disease: the occurrence of leprosy in a nonendemic area.
Leprosy, a rare chronic granulomatous communicable disease caused by Mycobacterium leprae, is classically known to have cutaneous and neurologic sequelae. As a result of immigration, the disease, endemic in Brazil, India, Nepal, Madagascar, Myanmar, and Indonesia, has been recognized to be present in North America and the Caribbean. We describe a case of a woman presenting with a long history of a recurrent rash and leg numbness, initially diagnosed with systemic lupus, who was later proven to have lepromatous leprosy. It is a reminder that this underappreciated disease should still be considered in the differential diagnosis of skin rash and neuropathy, even in nonendemic regions.
Flower
Cindy
C
School of Clinical Medicine and Research, University of the West Indies, Queen Elizabeth Hospital, Bridgetown, Barbados, West Indies. cflowerami@sunbeach.net
Gaskin
David
D
Marquez
Sean
S
D000505:Alopecia / Q000382:microbiology; D002637:Chest Pain / Q000382:microbiology; D003937:Diagnosis, Differential; D004641:Emigration and Immigration; D005260:Female; D006172:Guyana / Q000208:ethnology; D006801:Humans; D006987:Hypesthesia / Q000382:microbiology*; D015440:Leprosy, Lepromatous / Q000175:diagnosis*; D008875:Middle Aged; D019226:Oral Ulcer / Q000382:microbiology; D012216:Rheumatic Diseases / Q000175:diagnosis