A New Case of Leprosy with Atypical Morphotype on Slit Skin Smear- Unmasking a Hidden Invader

Diagnosing Hansen’s disease in a non-endemic region is challenging. Slit skin smear (SSS), remains one of the most useful and commonly utilized diagnostic modality in developing countries for microbiological diagnosis. Broken acid-fast bacilli (AFB) on SSS are an uncommon microbiological picture that should not be overlooked. Here, we present a new case of leprosy with atypical presentation: A 20-year-old native Kashmiri man, with history of non-healing ulcer left foot with microbiological picture of atypical morphotype of Mycobacterium leprae on SSS with no history of intake of anti-leprosy drugs. The patient had received treatment with antimicrobials for non-healing ulcer for some time, having partial suppressing effect on M. leprae, which might have contributed to this atypical microbiological presentation of bacilli on SSS.