Hidden in plain sight: A case of misdiagnosed leprosy mimicking rheumatoid arthritis
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Fatin Hanani Che Juha 1 2 , Nani Draman 1 2 * , Wan Noor Hasbee Wan Abdullah 3 , Norhafizah Abdul Rahim 4 , Siti Suhaila Mohd Yusoff 1 2
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1 Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, MALAYSIA2 Hospital Pakar Universiti Sains Malaysia, Kubang Kerian, Kelantan, MALAYSIA3 Department of Dermatology, Hospital Raja Perempuan Zainab II, Kota Bahru, Kelantan, MALAYSIA4 Department of Pathology, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, MALAYSIA* Corresponding Author

Abstract

Mycobacterium leprae is a causative agent of leprosy, a chronic granulomatous infection that primarily affects the skin and the peripheral nerves. Musculoskeletal involvement, including inflammatory arthritis, is quite common despite being under recognized. Leprosy presents protean manifestations, making it a great mimicker. Herein, we report a case of a 41-year-old Indonesian who resided in Malaysia for the past 20 years and presented with chronic joint pain and swelling of hands for a year, along with gradual facial swelling and numbness in the toes. Retrospectively, the patient noticed an erythematous skin lesion over the trunk and lower limbs 6 months before these symptoms, which did not improve with standard treatment for allergic reactions. These spectral manifestations and the subtle signs of leprosy led to a diagnostic delay of more than a year. In this study, we aim to enhance clinical awareness among primary care providers about recognizing, classifying, and appropriately treating the disease to prevent life-long deformity and disability.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Case Report

ELECTRON J GEN MED, Volume 22, Issue 1, February 2025, Article No: em620

https://doi.org/10.29333/ejgm/15848

Publication date: 13 Jan 2025

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