Facial rash in a 48-year-old woman: Case report of suspected leprosy in the emergency department.

Leprosy is a chronic infection caused by Mycobacterium leprae and Mycobacterium lepromatosis.^1–5 The reported global prevalence of leprosy has decreased from more than 5 million cases in the mid-1980s to 175 554 chronic cases in early 2015 and 213 899 new cases in 2014.⁶ With most cases arising in India, Indonesia, Brazil, and the Democratic Republic of the Congo,⁶ leprosy remains a rare disease in Canada, largely originating from immigration. Physicians’ lack of familiarity with the disease and low clinical suspicion make diagnosing leprosy challenging.^7,8 Additionally, this illness is highly stigmatized across various societies, resulting in discrimination and social isolation.^9,10 Cultural beliefs range from deeming those infected as being inferior people to being punished by God. As such, many steps have been taken to reduce stigmatization, such as referring to leprosy as Hansen disease.⁹

We report the case of a 48-year-old woman from the Philippines presenting to a Canadian emergency department (ED) with dermatologic manifestations suggestive of leprosy.