Leprosy\ or Hansen{\textquoteright}s disease\ is an infectious disease caused by the intracellular organism\ Mycobacterium leprae (M. leprae).\ The disease has a low prevalence in the United States and follows an indolent course with symptoms often manifesting several years after initial exposure. Reaching a diagnosis of Hansen{\textquoteright}s disease can often\ be challenging in a non-endemic setting.\ Additionally, reaching a diagnosis in the absence of skin symptoms is difficult, as the diagnostic method that provides the most clinical reliability is a skin biopsy or slit skin smear (SSS). Through this skin test, the acid-fast bacillus\ M. leprae\ is visualized.
We present a case of a 55-year-old woman from California who initially presented with neuropathy and continued to suffer\ from three years of progressive sensory and motor neuropathies before the diagnosis of Hansen{\textquoteright}s disease.\ She lived in a non-endemic setting but was likely exposed through her work in medical tourism in Playa del Carmen, Mexico.\ A diagnosis was ultimately reached once she presented with skin lesions that allowed for a biopsy.\ This case also highlights the challenge in reaching a timely diagnosis of Hansen{\textquoteright}s disease, which, due to its low prevalence in North America, can often be overlooked in a differential diagnosis.
}, year = {2026}, journal = {Cureus}, volume = {18}, pages = {1 - 8}, month = {05/2026}, publisher = {Springer Science and Business Media LLC}, issn = {2168-8184}, url = {https://assets.cureus.com/uploads/case_report/pdf/376661/20260525-114090-bkddct.pdf}, doi = {10.7759/cureus.109634}, language = {ENG}, }