Leprosy presenting with pruritus mimicking dermatitits artefacta: understanding the significance of recognizing initial clinical manifestations

Abstract

Leprosy is a chronic, curable, infectious granulomatous disease caused by acid-fast bacilli (AFB) from the Mycobacterium leprae complex. Early diagnosis allows for appropriate treatment, preventing transmission and potential neurological sequelae. This report describes a case of a 67-year-old male patient who has presented with complaints of "allergy," experiencing itching in the left upper limb, accompanied by scratches, with skin lesions suggestive of factitious dermatitis. Months after treatment, he developed new ulcerated lesions and was diagnosed, through clinical and histopathological examination, as having dimorphic-Virchowian leprosy. In this sense, the clinical diagnosis of leprosy can be significantly challenging, especially considering its complex pathology, diverse symptoms, delayed progression, and varying immune responses