Chronic Hand Swelling and Dactylitis in Leprosy: A Case Report and Review of the Literature

Abstract

Leprosy is an infectious disease that is associated with various types of presentations. Diagnosis of the disease can be tricky in cases of atypical presentations. We report a unique case of leprosy characterized by chronic hand swelling, dactylitis, and seropositive laboratory markers, which was diagnosed in a rheumatology clinic.

Leprosy-Related Chronic Arthritis with an Abundance of Mycobacterium Leprae in the Synovial Fluid: A Rare Case

“…Nevertheless, arthritis in leprosy can be categorized into the following groups: (i) Charcot’s joints, (ii) septic arthritis, (iii) acute polyarthritis of lepra reaction, and (iv) chronic arthritis. 4 , 5 , 8 Charcot’s joints, otherwise known as neuropathic arthropathy, manifests as joint dislocations, pathological fractures, and debilitating deformities usually involving the weight-bearing joints of the lower limbs, such as ankles and the knees. 4 , 13 Acute arthritis in leprosy usually occurs as part of leprosy reactions.…”

“… 1 , 2 , 3 Following the skin and nerves, bone and joint changes are the third most common manifestation of leprosy. 4 , 5 The diagnosis of leprosy can be a problem for clinicians when musculoskeletal features constitute the initial presentation with minimal or even none of the skin or nerves involvement. 5 Furthermore, musculoskeletal problems in leprosy can resemble other connective tissue disorders, which may lead to misdiagnosis and mistreatment.…”

“… 6 Therefore, it is important for clinicians to have good knowledge about several aspects of this condition. 5 In addition, the examination and early treatment of bone and joint complications can reduce disabilities and deformities in leprosy. 1 , 4 , 7 This case report aimed to show a rare finding of abundant Mycobacterium leprae in the synovial fluid of a lepromatous leprosy patients with bone changes and leprosy-related chronic arthritis.…”

Post Ambulatory Swollen Hands (POTASH): An Autobiographical Case Report

“…The unanticipated development of hand swelling may be a cause of concern and often requires additional assessment [3]. The initial evaluation should determine whether the onset of hand swelling was acute (for which some of the causes are listed in Table 1 [1][2][3][4][5][6][7][8][9][10][11]) or chronic (for which some of the causes are listed in Table 2 [3,[12][13][14][15][16][17][18][19][20]). In addition, the examination should consider the presence of numbness, pain, pruritus, tingling or warmth (or the absence of symptoms), the color changes of the affected area, and whether the condition persists, or resolves (either spontaneously or following treatment).…”

“…Hand swelling can result from either intrinsic (such as a tumor) or extrinsic (such as an arthropod assault) causes. The swelling can be limited to only the hands (such as allergic contact dermatitis) or a component of a systemic condition (such as mixed connective tissue disease) [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”