Lepromatous Leprosy in a Patient with B-Cell Lymphoma and Tubulointerstitial Nephritis

eprosy is an ancient disease, and although the treatment for leprosy has been available for several decades, the number of cases of leprosy worldwide was recently estimated to be approximately 5.5 million. 1 Most cases of leprosy occur in tropical countries. In the United States, indigenous transmission has been recorded in Hawaii, Pacific island territories, and sporadically along the Gulf Coast. 2 Generally, patients with leprosy do not experience increased morbidity as a result of viral, fungal, or protozoal infections, for which cellular immunity is an important defense mechanism. Mycobacterium leprae infection has not been shown to predispose patients to an increased risk for neoplasia, 2 and Hodgkin’s lymphoma has rarely been reported in a patient with leprosy. 3 In contrast, several cases of leprosy have been reported in patients with non-Hodgkin’s T-cell lymphoma. 4 This article reports the case of a patient with lepromatous leprosy and B -c ell lymphoma whose clinical presentation with inguinal and axillary lesions preceded the development of cutaneous lesions by 1 week. CASE PRESENTATION A 54-year-old white man presents to an ambulatory medicine clinic with an approximately 7-week history of worsening diffuse erythematous rash that has become more pruritic, dry, and scaly.