Diagnostic difficulty-an elusive case of Hansen’s disease mimicking sarcoidosis

Hansen´s disease (leprosy) is caused by a slow-growing type of bacteria called Mycobacterium leprae (M. leprae). It is an age-old disease that has been around since biblical times yet cases still occur especially in Asia and Africa, despite concerted global efforts to eradicate the disease. Chemotherapeutic agents are available and effective once administered appropriately and adequately. We report an elusive case of Hansen’s disease wherein the only symptom was a nodule on the nasal bridge in an otherwise healthy woman for over one year. Repeated examinations and investigations in different centers were suggestive of sarcoidosis and she was left untreated for leprosy for the period. A skin biopsy was carried out for histopathology diagnosis. Histology confirmed borderline lepromatous leprosy. This case demonstrates the need for a definitive diagnosis of leprosy to reduce the spread of this contagious disease especially in tune with the concerted global efforts.