Lepromatous Leprosy Presenting With Preserved Sensation: A Case Report

Leprosy, which is also called Hansen's disease, is a chronic infectious disease that predominantly affects the skin and the nerves. It is caused by Mycobacterium leprae. The skin, peripheral nerves, upper respiratory tract mucous surface, and the eyes are mostly affected during the course of the disease. Leprosy can occur at any age, from early infancy to very old age. This case report describes a 43-year-old Nigerian man who works as a timber contractor. He presented with a month's history of the eruption of non-itchy papules first noticed on the face and progressively worsened till the patient had infiltration of the facial skin with leonine facie. Similar papules and nodules were noted in other parts of the body. The nodules on the lower limbs were ulcerated and septic. The earlobes were also infiltrated with oil-drop nodules. There was a history of weight loss, noticed at the same time as the lesions. Skin biopsy was done for histology and immunohistochemistry; results confirmed the diagnosis of lepromatous leprosy. Of relevance in this case report is the fact that light touch sensation was preserved in all the affected parts of the body at the initial presentation. Following diagnosis, our patient was counseled and was subsequently commenced on multi-drug therapy comprising rifampicin, dapsone, and clofazimine, with clinical improvement.