01951nas a2200229   4500000000100000008004100001260001000042653002000052653001300072653001300085653002500098653002200123100001200145700001700157700001200174700001200186245010300198856026000301490000700561520113900568022001401707       2025                            d  bLepra10aAdverse effects10aSteroids10a leprosy10aMycobacterium leprae10aleprosy incognito1 aNanda S1 aSushantika S1 aSaini K1 aKumar A00a“Leprosy incognito”: A case report of unusual presentation of topical steroid-modified leprosy  uhttps://www.researchgate.net/profile/Dr-Sushantika/publication/394324346_Leprosy_incognito_A_case_report_of_unusual_presentation_of_topical_steroid-modified_leprosy/links/6892ec4542b47114347c7150/Leprosy-incognito-A-case-report-of-unusual-presentation-of-0 v963 a<p>Summary Leprosy, one of the great imitators, can present with diverse clinical manifestations, often making it challenging to diagnose. We report an unusual case of steroid-modified leprosy in a 50-year-old man who presented with an erythematous, atrophic plaque with telangiectasia over the left periorbital area and mild sensory loss. The lesion had intensified in redness after prolonged application of topical corticosteroids prescribed for presumed contact dermatitis. Histopathology revealed granulomatous inflammation with perineural involvement. Slit-skin smear confirmed Mycobacterium leprae (BI-2+, MI-10%). A diagnosis of TT Hansen’s was made, and WHO-recommended multidrug therapy was initiated. The absence of acute inflammation ruled out a type 1 lepra reaction. The clinical appearance mimicked topical steroiddamaged facies, highlighting the need to consider leprosy as a differential of atypical steroid-modified dermatoses. To our knowledge, this is the first report of “leprosy incognito,” an entity analogous to tinea incognito, underscoring the importance of awareness to avoid diagnostic delays.</p>
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