Subcutaneous nodules and joint deformity in leprosy: case report and review

Leprosy (Hansen's disease), known to be caused by Mycobacterium leprae, is a well-known illness with multiple rheumatologic manifestations. This chronic granulomatous infection has clinical features that are variable, depending on the immune response of the host. Manifestations consist mainly of involvement of the peripheral nerves, skin, upper respiratory system, eyes, and testes, as well as joints. Musculoskeletal manifestations include arthralgias, arthritis, Charcot arthropathy, and positive autoantibodies. We report a case of a Puerto Rican-born woman who was living within the northeastern United States and had subcutaneous nodules, saddle nose deformity, and painless contractures of her fingers and toes. This case illustrates some of the musculoskeletal manifestations of leprosy to raise awareness of this disease as part of the differential diagnosis of articular abnormalities with subcutaneous nodules in a nonendemic country.