01724nas a2200253   4500000000100000008004100001653002200042653001500064653002400079653002300103653001200126100001400138700001100152700001300163700001100176700001600187700001900203245008600222856007100308300001000379490000700389050001600396520105800412       2013                            d10aNon-pitting edema10aIchthyosis10aSymmetric arthritis10aBorderline leprosy10aleprosy1 aMoulick A1 aJana A1 aSarkar N1 aGuha P1 aMahapatra C1 aLallawmzuala K00aNon pitting edema, arthritis and ichthyosis : presenting manifestation of leprosy  uhttp://www.ijl.org.in/2013/4%20A%20Maulick%20et%20al%20(83-86).pdf  a83-860 v85  aMOULICK20133 aLeprosy is a chronic granulomatous infection caused by Mycobacterium leprae. Predominantly involving skin
and nerves and having classic clinical description, the diagnosis may be clear-cut in majority of patients but
may be challenging in others. Non-pitting edema, ichthyosis and arthritis are uncommon in leprosy and very
rare in tuberculoid type where the diagnosis may be challenging unlike relatively clear-cut clinical picture in
lepromatous type. Musculoskeletal manifestation is seen in 1-5% of cases and usually associated with
reactional states where again the diagnosis sometimes becomes evident. High index of suspicion is therefore
recommended in patients with unexplained systemic illness especially in endemic areas. Herein we report a
young male with non pitting edema and symmetric peripheral arthritis involving all four limbs, and ichthyosis
as presenting manifestation of borderline leprosy where the neuro-cutaneous manifestation developed two
months after the said presenting features and in absence of a reactional state.