NEUROPATHY AS THE ONLY SIGN OF BORDERLINE LEPROMATOUS LEPROSY FOR 13 YEARS

A 57-year-old man experienced numbness in his right hand in 1975 and t hen noticed weakness and sensory disturbance in his legs. The neurolog ical symptoms were suggestive of a degenerative neural disease, such a s Charcot-Marie-Tooth disease. However a diagnosis of leprosy was esta blished because of nerve enlargement and tenderness and after a nerve biopsy. The patient did not have any skin lesions. Treatment was initi ated with diaminodiaphenylsulfone (DDS) and discontinued one year late r at the patient's request. Various asymmetric eruptions first appeare d on his body in 1988. Based on the 5+ average bacterial index of erup tions and the negative lepromin reaction in addition to the clinical p ictures, he was diagnosed as having borderline lepromatous leprosy. Ou r case is a very rare type of borderline lepromatous leprosy in which peripheral neuropathy preceded the onset of skin lesions by 13 years.