Abstract
An elderly male presented with asymptomatic nodules on the hands and feet of 1 year duration. A few similar lesions were noted on the chest too. There was symmetrical and bilateral loss of sensation over the hands and feet, up to mid-forearm and mid-calf level. However, there were no facial lesions, ear lobe infiltration, or madarosis. Histoid leprosy and lepromatous leprosy were considered as clinical differentials, and biopsy from the nodule on the hand was done. Biopsy showed dense nodular monomorphous infiltrate of foamy histiocytes involving the reticular dermis and sparing the upper dermis. Slit skin smear from the lesion showed acid-fast bacilli in clumps with BI >5+. On clinicopathological correlation, diagnosis of lepromatous leprosy was made.KeywordsLeprosyLepromatous leprosyHistoid leprosyAcid-fast bacilliAcral nodules
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