Deck chair sign in lepromatous leprosy

A 40-year-old male presented with generalized asymptomatic cutaneous infiltrated plaques involving trunk, limbs and face. He had acral sensory loss along with symmetrical nerve thickening and enlargement. Slit-skin smear revealed multiple acid-fast bacilli (AFB) on Wade-Fite staining, thus confirming the diagnosis of lepromatous leprosy. Patient had a remarkable sparing of skin creases at various sites including trunk, antecubital fossa and axillary flexures suggestive of a positive “Deck Chair Sign”. This sign has been described in literature mostly in papuloerythroderma of Ofuji and other related dermatosis. To our knowledge this is the first case report of ‘lepromatous leprosy with deck chair sign’ from Pakistan.