Uncommon Presentation of Lepromatous Leprosy in a Nonendemic Setting: A Case Report

Leprosy, caused by Mycobacterium leprae, remains a significant public health concern in certain endemic regions, but it is rarely encountered in nonendemic areas, posing diagnostic challenges. This case report discusses an unusual presentation of lepromatous leprosy in a patient residing in Saudi Arabia with no history of travel to endemic regions. The patient's clinical features were atypical, lacking the classic neurological involvement and sensation loss commonly associated with leprosy. Definitive diagnosis was achieved through histopathological examination revealing diffuse histiocytic infiltrates, a grenz zone, and acid-fast bacilli confirmed by modified Ziehl-Neelsen staining. The patient responded well to multidrug therapy according to WHO guidelines. This case highlights the importance of maintaining high clinical suspicion, utilizing appropriate diagnostic techniques, and understanding the epidemiological complexities of leprosy in low-prevalence settings. Strengthening awareness and surveillance is essential to prevent underdiagnosis and curb transmission in nonendemic regions.