From Eczema to Hansen’s Disease: A Case of Diagnostic Oversight

While eczema is a common skin condition, not every chronic rash should be treated as such. A 54-year-old woman presented with persistent, erythematous-to-hyperpigmented lesions on her upper trunk. Despite repeated treatments for presumed eczema, her symptoms persisted. Upon referral, histopathological evaluation revealed dermal granulomas with Langhans giant cells and epithelioid histiocytes - findings consistent with borderline tuberculoid leprosy. She was promptly initiated on multibacillary multidrug therapy (MB-MDT). This case highlights that even in endemic regions, leprosy may be overlooked in atypical clinical presentations.