Lepromatous Leprosy With Erythema Nodosum Leprosum

Leprosy remains an important mimicker of autoimmune and inflammatory disease, particularly in nonendemic settings. A 30-year-old man from Micronesia presented with synovitis, subcutaneous nodules, and ocular inflammation, with negative rheumatologic serologies. Biopsy findings confirmed erythema nodosum leprosum. This case highlights the overlap between infectious and rheumatologic presentations where delayed recognition can occur.