Non-Trophic Cutaneous Ulcers in Lepromatous Leprosy

A 44-year-old woman had progressive burning parasthesias and sensory loss in both upper and lower limbs, followed by weakness of distal muscles of the hands and feet for four years. She had redness and swelling of both hands and feet, multiple painless ulcers over the dorsum of the fingers (Figure 1A) and feet (Figure 1B), and thickened, non-tender, bilateral, ulnar, superficial cutaneous branch of radial and common peroneal nerves. She also had predominant small fiber sensory polyneuropathy in a glove and stocking pattern, intrinsic muscle weakness of the hands and feet, and intact deep tendon reflexes. Results of hematologic and biochemical tests were within references ranges. Tests results for vasculitis and viral markers were negative. A nerve conduction study showed asymmetrical predominantly axonal sensorimotor polyneuropathy (Figure 3) and