University of Wisconsin–Madison Medical College of Wisconsin

Leprosy in the Upper Midwest

Kathy Bach, MD; Molly A. Hinshaw, MD; Bridget E. Shields, MD

WMJ. 2023;122(3):205-207

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Introduction: Leprosy is a life-threatening infection caused by Mycobacterium leprae with an average 5-year long incubation period. It is curable when treated early. Early diagnosis requires knowledge of its myriad clinical features as risk factors may not be readily apparent.

Case Presentation: We report the case of a male patient from Wisconsin who tested positive for leprosy without a known exposure or recent travel to endemic areas.

Discussion: The clinical presentation of leprosy exists on a spectrum and correlates with cell immunity levels. The Ridley-Jopling and World Health Organization classifications are used to define leprosy subtypes and guide treatment. Histopathologic examination may aid in diagnosis of suspicious presentations.

Conclusions: Leprosy may present with nonspecific clinical features and elevated inflammatory markers leading to a misdiagnosis. It should be considered on the differential diagnosis for suspicious presentations and appropriately worked up with various diagnostic modalities. A multidisciplinary approach to treatment may prevent spread and permanent damage.

Author Affiliations: University of Wisconsin School of Medicine and Public Health (UWSMPH), Madison, Wisconsin (Bach); Department of Dermatology, UWSMPH, Madison, Wis (Hinshaw, Shields).
Corresponding Author: Bridget E. Shields, MD, FAAD, Department of Dermatology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792; email; ORCID ID 0000-0002-5734-0167
Funding/Support: None declared.
Financial Disclosures: None declared.
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