15533 Lupus or leprosy? A tale of two diseases

Leprosy and systemic lupus erythematosus (SLE) share many clinical and laboratory characteristics1. Clinically, both diseases may present with skin lesions, peripheral neuropathy, and arthritis. They also share serologic similarities, including ANA2,3, anti-TPO3, RF, ANCA, anti-CCP4, aPL5, AMA, anti-La/SSB, and anti-cardiolipin antibodies. Further confounding the distinction is the possibility that patients may truly have both diseases concurrently. At the moment, there is no consensus on how to distinguish between leprosy-induced SLE-like symptoms and true SLE. Here we present the case of a 43-year-old African-American woman who was originally diagnosed with SLE before skin biopsy revealed leprosy. As she had no risk factors for leprosy, we suggest considering the diagnosis in even seemingly low-risk patients with SLE-like symptoms. We discuss her symptoms and laboratory findings in the context of both SLE and leprosy and highlight the importance of early diagnosis and intervention to decrease neurologic sequelae associated with leprosy.