Interesting and unusual clinical presentations in leprosy at a referral center
A 38-year-old male, nondiabetic, was referred to our center for a slit-skin smear. The patient had a history of loss of sensation on the lateral aspect and heel of the left foot since three months. Past and family history was negative for neuropathy or leprosy. On examination, fine touch sensation was absent, whereas crude touch sensation was diminished in the left lower extremity. Left ulnar nerve, lateral peroneal, anterior tibial, and sural nerves were thickened. No hypopigmented patches were found. A diagnosis of leprosy was doubtful with such a short duration of complaints but EMG/NCS done before the patient was referred to us demonstrated left sural neuropathy. Therefore, a left sural nerve biopsy was done which showed granulomas comprising lymphocytes, macrophages, and epithelioid cells within and around fascicles. A borderline tuberculoid type of leprosy was diagnosed.