Multibacillary Leprosy Presenting as Anetoderma in a Young Teenager

Area of Science:

• Dermatology
• Infectious Diseases
• Public Health

Background:

• Anetoderma, characterized by localized slack skin, can be primary or secondary to other conditions.
• Leprosy is an uncommon cause of secondary anetoderma, particularly in multibacillary forms.
• Diagnosing leprosy is crucial, especially in regions aiming for disease elimination.

Observation:

• A 16-year-old girl presented with fever, joint pain, and three anetodermic plaques.
• Slit skin smear revealed numerous acid-fast bacilli (bacillary index 3+), confirming leprosy.
• This presentation is unusual for multibacillary leprosy, especially in a young patient from a leprosy-eliminated country.

Findings:

• The case demonstrates an atypical presentation of multibacillary leprosy.
• Few anetoderma lesions were the primary manifestation in this adolescent.
• The diagnosis was confirmed via slit skin smear, identifying acid-fast bacilli.

Implications:

• This case underscores the need to consider leprosy in the differential diagnosis of anetoderma, irrespective of geographical leprosy prevalence.
• Early diagnosis and treatment are vital for managing leprosy and preventing complications.
• Healthcare providers should maintain vigilance for leprosy, even in populations where it is considered eliminated.