01236nas a2200193   4500000000100000008004100001260001200042100001300054700001300067700001300080700001600093700001500109700001400124245006000138300001200198490000700210520081100217022001401028       2021                            d  c01/20211 aHoesly P1 aCappel M1 aHoesly F1 aSluzevich J1 aTolaymat L1 aKeeling J00aLeprosy as a Diagnostic Challenge in the United States.  a137-1410 v193 a<p>A 63-year-old woman from Central Florida presented to an outside clinic with a 2-year history of a progressive, asymptomatic cutaneous eruption and arthralgias. Her past medical history was significant for reported seronegative rheumatoid arthritis, for which adalimumab, methotrexate, and low-dose prednisone therapy were initiated 5 years prior. The skin eruption occurred shortly after a 4-week hospitalization during which these medications were withheld. At her initial outside evaluation, a biopsy was performed and interpreted as subacute cutaneous lupus erythematosus (SCLE). She was treated with hydroxychloroquine without improvement. A repeat biopsy was reported as consistent with interstitial granulomatous dermatitis (IGD). There was no improvement with potent topical corticosteroids.</p>  a1751-7125