Lepromatous leprosy with an atypical psoriasiform presentation mimicking psoriasis: a case report

Leprosy, just like syphilis, has become a great imitator with its various atypical and unusual presentations. It presents in many diverse ways and can be confused with many infectious and non-infectious forms.It is often misdiagnosed as common disorders like psoriasis, pyoderma, angioedema, pre-vitiligo, sarcoidosis, and granuloma annulare. Appropriate history-taking with good clinical examination is required to diagnose atypical presentations of leprosy. Early diagnosis along with appropriate treatment is essential to prevent disability and other complications. We outline a case of lepromatous leprosy with an atypical psoriasiform presentation that mimicked psoriasis. Psoriasiform leprosy presents as erythematous plaques of varying sizes and shapes on the extensor regions of trauma-prone sites like the knees, elbows, and buttocks. This condition mimics psoriasis and is diagnosed as leprosy based on the slit skin smear and histopathology with a special Fite-Faraco stain.