Histoid leprosy – unusual presentation

A 39‐year‐old man presented with a chronic nonhealing toe ulcer and multiple skin‐colored papules on the back, arms, and knees. From an initial small erosion, the toe lesion ulcerated over a 1.5‐year period, while the papules progressed over a 6‐month period, first appearing on the back and then spreading to the arms and knees. The past medical and family history were noncontributory. Pertinent findings included the aforementioned well‐defined, asymmetric, shiny papules ( Fig. 1 ). There were multiple, discrete, erythematous, pedunculated, tumor‐like masses of various sizes over the right thigh ( Fig. 2 ) and a well‐defined 4 cm × 3 cm ulcer on the second toe of the left foot, the floor of which was covered by necrotic slough.