Introduction

Leprosy, also known as Hansen’s Disease, is a chronic granulomatous bacterial disease due to infection with Mycobacterium leprae bacilli affecting mainly skin and peripheral nerves. It can also affect the eyes, mucous membranes, bones, cartilage, joints, and testes producing a spectrum of clinical presentations and has the potential to cause severe disfigurement of the affected individuals.1–3Elimination of leprosy as a public health problem globally was achieved in 2000 and most countries including Nepal by 2010.1,4–6 In 2020, Globally 127,396 new cases were reported with a case detection rate of 16.4 per million population. Brazil, India, and Indonesia reported 72.5% of registered cases and 74% of new cases detected in 2020. In Nepal 2304 new cases were detected in 2020.4 Diagnosis might be delayed due to unusual presentation or mimicking other Rheumatological diseases especially when presented along with polyarthritis.7–10 Early detection and treatment are critical for preventing neuropathy and disability. Here we present a case of a 67-year-old male with a delay in diagnosis of leprosy who has suffered for almost one and half years due to its resemblance to seronegative rheumatoid arthritis initially and unaware of variation of clinical presentation in leprosy.