# Leprosy Presenting With Scleroderma and Cataract: A Clinical Conundrum

## TL;DR

A 64-year-old woman presented with a rare combination of leprosy, scleroderma, and cataract, highlighting the importance of accurate diagnosis and treatment.

## Contribution

This case report highlights the co-occurrence of lepromatous leprosy, scleroderma, and cataract, emphasizing the need for integrated clinical evaluation.

## Key findings

- The patient exhibited hypopigmented patches, sensory loss, and digit resorption consistent with lepromatous leprosy.
- Skin thickening and functional impairments indicated overlapping scleroderma symptoms.
- Sclerotic cataract was diagnosed alongside leprosy, requiring multidrug treatment and pulse therapy.

## Abstract

Leprosy, a chronic infectious disease caused by Mycobacterium leprae, even though treatable, remains a significant public health problem. It mainly impacts the skin, peripheral nerves, mucosa of the upper respiratory tract, and the eyes. In this case report, we present the case of a 64-year-old female with numerous hypopigmented patches with loss of sensations, madarosis, resorption of toes and digits, skin tightening, and diminution of vision. The skin over the hands exhibited thickening, leading to functional impairments that influenced both manual dexterity and mobility. The diagnosis of this unique case, showing a complex triad of lepromatous leprosy, scleroderma, and sclerotic cataract, was confirmed by clinical evaluation, skin biopsies, serological tests, and ophthalmic examination. Following this, the patient underwent dexamethasone-cyclophosphamide pulse therapy and multidrug treatment to halt the disease progression, prevent further disability, and reduce transmission. The case management addressed the issue of overlapping symptoms and conditions to provide appropriate care and cure to the patient. Public health initiatives under the National Leprosy Eradication Programme play an important role in promoting early diagnosis, effective treatment, and community empowerment, working toward a future where leprosy is no longer a threat to public health by preventing disability, reducing transmission, and combating the social stigma associated with it.