# Marked by stigma, inked by belief: tattooing in leprosy – a community perspective

## TL;DR

A 28-year-old woman with leprosy delayed treatment due to cultural beliefs, showing how stigma and traditional practices can hinder proper medical care.

## Contribution

The case highlights the impact of cultural stigma and traditional tattooing practices on delayed leprosy diagnosis and treatment.

## Key findings

- The patient delayed seeking care for 8 months due to cultural beliefs.
- Tattooing by a traditional healer was used in an attempt to contain the disease.
- Multidrug therapy and counseling were initiated after diagnosis confirmation.

## Abstract

Leprosy remains a public health challenge in India, not merely due to medical reasons but because of persistent stigma and deep-rooted cultural beliefs that influence health-seeking behaviour. This case report describes a 28-year-old woman with borderline tuberculoid leprosy who delayed seeking medical care due to cultural beliefs.

After an 8-month delay in seeking medical care, the patient presented with a hypopigmented, hypoesthetic patch over the right knee, along with thickening of the right common peroneal nerve. Notably, two sets of intersecting tattoo lines were observed over the lesion applied by a traditional healer in an attempt to contain the disease. Histopathology confirmed a diagnosis of borderline tuberculoid leprosy, and high-resolution ultrasonography corroborated peripheral nerve involvement. The patient was subsequently given multidrug therapy for multibacillary leprosy, adult regimen for 12 months and received detailed counselling on disease management.

The case highlights how cultural practices can hinder early diagnosis and effective management. Culturally sensitive health education is essential to combat stigma and improve leprosy control.