Skin abnormalities and polyneuropathy: Consider leprosy

The incidence of leprosy in the Netherlands is now low, which can lead to incorrect diagnosis by the clinician. When this happens, leprosy can become very incapacitating. We describe a case of a young woman with hypopigmented and insensitive macules on the skin; she also suffered from pain and loss of strength in her legs. She consulted a neurologist, a rehabilitation specialist and a dermatologist, but it was many years before a diagnosis was made. In the meantime, this woman had become unemployed and the disease was still progressive. When leprosy was confirmed, she was treated with multibacillary multidrug therapy. The combination of hypopigmented macules on the skin and loss of sensitivity is a very important clue in reaching a diagnosis of leprosy. It is important to draw attention to the symptoms of this disease to ensure that the right diagnosis is made on time.