01268nas a2200277   4500000000100000008004100001260001300042653001400055653002800069653000900097653001100106653002300117653001200140653000900152653001600161653001400177653000900191100001700200700001400217700001400231245005200245300001000297490000600307520066300313022001400976       1989                            d  c1989 Jun10aArthritis10aDiagnosis, Differential10aHand10aHumans10aLeprostatic Agents10aleprosy10aMale10aMiddle Aged10aParalysis10aToes1 aMarkusse H M1 aSmelt A H1 aTeepe R G00aUnusual arthritis: be on the alert for leprosy.  a266-80 v83 a<p>A 50-year-old Indonesian man presented with arthritis of the left ankle, wrist and hand joints and a diffusely swollen left hand and foot. A few months later granulomatous skin lesions developed and renewed physical examination revealed a paresis of the intrinsic muscles of the left hand and the left M. extensor hallucis longes and thickening of several peripheral nerves. The skin lesions appeared to be anesthetic. A diagnosis of borderline tuberculoid leprosy was made and treatment resulted in cure with permanent peripheral nerve damage. This case emphasizes the importance of early recognition and treatment of leprosy to prevent nerve damage.</p>  a0770-3198