01342nas a2200157   4500000000100000008004100001653003000042653001900072653001200091653002500103100001100128245008300139856006700222300000800289520088700297       2024                            d10aErythema Nodosum Leprosum10aLepra reaction10aLeprosy10aRheumatoid arthritis1 aKori D00aHansen’s disease with lepra reaction presenting as a rheumatological disease  uhttps://chanrejournals.com/index.php/ijcr/article/view/214/387  a1-43 a<p>The case study presents a complex case of leprosy with two types of lepra reaction, closely mimicking autoimmune disorders. The patient exhibited symptoms for 10 years, including skin rash and ulcers, followed by symmetric polyarthritis and back pain. Comprehensive examination revealed symmetric small and large joint polyarthritis, small ulcers on the lateral aspect of the left lower leg, hyperkeratotic skin lesions on both hind feet, reduced sensation in both feet and soles, as well as hypopigmentation. The provisional differential diagnoses included rheumatoid arthritis with vasculitis, polyarteritis nodosa (PAN) vasculitis, or rheumatic manifestations of Hansen’s disease including type 1 and type 2 lepra reaction. This case study underscores the importance of conducting a comprehensive clinical evaluation to differentiate it from autoimmune manifestations.</p>