01422nas a2200169   4500000000100000008004100001260001600042653001600058100001100074700001400085700001200099245005100111300001000162490000700172520105900179022001401238       2020                            d  bElsevier BV10aDermatology1 aZhou C1 aReardon K1 aAllen P00a15533 Lupus or leprosy? A tale of two diseases  aAB1550 v833 aLeprosy and systemic lupus erythematosus (SLE) share many clinical and laboratory characteristics1. Clinically, both diseases may present with skin lesions, peripheral neuropathy, and arthritis. They also share serologic similarities, including ANA2,3, anti-TPO3, RF, ANCA, anti-CCP4, aPL5, AMA, anti-La/SSB, and anti-cardiolipin antibodies. Further confounding the distinction is the possibility that patients may truly have both diseases concurrently. At the moment, there is no consensus on how to distinguish between leprosy-induced SLE-like symptoms and true SLE. Here we present the case of a 43-year-old African-American woman who was originally diagnosed with SLE before skin biopsy revealed leprosy. As she had no risk factors for leprosy, we suggest considering the diagnosis in even seemingly low-risk patients with SLE-like symptoms. We discuss her symptoms and laboratory findings in the context of both SLE and leprosy and highlight the importance of early diagnosis and intervention to decrease neurologic sequelae associated with leprosy.  a0190-9622