Authors : Juliah Wangari Muchunu; Badria Kombe Mushi; Ashraf Yusuph; Twijise Ambah Mwamfupe; Neema Ezekiel Kunyaranyara; Godwin Silas Macheku

Volume/Issue : Volume 11 - 2026, Issue 9 - September

DOI : https://doi.org/10.38124/ijisrt/26sep1450

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Abstract : : Lepromatous leprosy remains a significant public health challenge in endemic regions of East Africa. Here, we describe a 31-year-old previously healthy male artisan from the Tanga Region of Tanzania who presented with a one-year history of painless papulonodular lesions of the face and extremities, progressive hand edema, and unnoticed sensory loss that culminated in an accidental burn. Examination revealed diffuse facial infiltration, madarosis, bilaterally thickened nodular earlobes, multiple firm papulonodules, peripheral-nerve thickening, and sensory impairment. Ziehl–Neelsenstained slit-skin smears demonstrated numerous acid-fast bacilli, confirming multibacillary (lepromatous) leprosy by World Health Organization (WHO) operational criteria. Concurrent features of type 2 lepra reaction (erythema nodosum leprosum, ENL) were present. The patient received the standard 12-month WHO multidrug therapy (MDT) regimen for multibacillary disease, together with a tapering course of oral corticosteroids. Marked regression of nodules, softening of earlobes, and resolution of reactional lesions were observed. This case underscores the diagnostic value of simple clinical examination and slit-skin smear microscopy in resource-limited settings and the necessity of simultaneous antimicrobial and anti-inflammatory therapy to prevent irreversible nerve damage.

Keywords : Lepromatous Leprosy; Multibacillary Leprosy; Erythema Nodosum Leprosum; Type 2 Lepra Reaction; Tanzania; Multidrug Therapy; Case Report.

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