DIAGNOSTIC DELAY IN MULTIBACILLARY LEPROSY: LEARNING FROM A CASE

Abstract

Leprosy remains a preventable cause of disability, and diagnostic delay continues to be a clinical and publichealth challenge,  particularly in multibacillary forms prone to type 2 reactions. We present the case of a 39 year old woman with an 18-month 
history of macular and nodular cutaneous lesions on the extremities, who sought care on multiple occasions with only partial improvement after corticosteroids. In the last month, the lesions became painful. Skin biopsy was compatible with multibacillary
leprosy with erythema nodosum leprosum, and multidrug therapy plus corticosteroids was initiated. The combination of nodules on the upper and lower limbs, a conclusive slit-skin smear, and concordant histopathology should heighten suspicion for Hansen’s disease and justify prompt, targeted sampling and immediate treatment, thereby mitigating the consequences of
delayed diagnosis.