Leprosy with vascular involvement mimicking Buerger's disease

Leprosy presenting with vascular involvement is very rare or is probably under-reported. Arteriographic and histopathological analysis has shown vascular involvement in few individuals with leprosy previously. It has also been found that vascular abnormality is central to the pathogenesis of trophic ulcer and nerve damage itself. A 37-year-old male presented to our center with pain, bluish discoloration and recurrent ulceration of digits of hands and feet of twelve months duration. Investigations revealed diminished caliber of the brachial artery with no other underlying abnormality. Dermatological review revealed features of primary neuritic leprosy confirmed by nerve biopsy and polymerase chain reaction (PCR) for Mycobacterium leprae positivity. This case highlights the fact that vascular involvement could rarely be a primary event in leprosy and cause Buerger's disease-like manifestations.

Automated summary

Leprosy with vascular involvement is rare and often goes under-reported. Previous studies have shown that vascular abnormality is central to the development of trophic ulcers and nerve damage in leprosy. This case report highlights a 37-year-old male with pain, bluish discoloration, and recurrent ulcers on his hands and feet, which were found to be associated with diminished caliber of the brachial artery. Further investigations confirmed primary neuritic leprosy, suggesting that vascular involvement can rarely be a primary event in leprosy and lead to Buerger's disease-like manifestations.