Dual arthropathy in previously treated multibacillary leprosy: Inflammatory polyarthritis with neuropathic ankle destruction in an endemic setting

A 51-year-old woman previously treated for multibacillary leprosy presented with polyarthritis of wrists, ankles and small joints of the hands, resembling rheumatoid arthritis. She had completed multidrug leprosy therapy in 2014 and had a previous history of erythema nodosum leprosum treated with corticosteroids. Slit-skin smear demonstrated acid-fast bacilli and skin biopsy confirmed granulomatous inflammation consistent with leprosy. She was treated with anti-inflammatory therapy and rehabilitation measures, resulting in gradual clinical improvement.