{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T19:44:07Z","timestamp":1775936647504,"version":"3.50.1"},"reference-count":10,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,7,26]],"date-time":"2016-07-26T00:00:00Z","timestamp":1469491200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Leprosy is a chronic granulomatous infection caused by <jats:italic>Mycobacterium leprae<\/jats:italic> with predominant involvement of skin and nerves. We present a 70\u2010year\u2010old man with leprosy whose initial presentation resembled rheumatologic disease, due to leprae reaction. He presented with an 8\u2010week history of worsening neuropathic pain in the right forearm, associated with necrotic skin lesions on his fingers that had ulcerated. Physical examination revealed two tender necrotic ulcers at the tip of the right middle finger and the dorsal aspect of the left middle finger. The patient had right wrist tenosynovitis and right elbow bursitis. Apart from raised inflammatory markers, the investigations for infection, connective tissue disease, vasculitis, thromboembolic disease and malignancy were negative. During the fourth week of hospitalization, we noticed a 2\u2010cm hypoesthetic indurated plaque on the right inner arm. Further examination revealed thickened bilateral ulnar, radial and popliteal nerves. A slit skin smear was negative. Two skin biopsies and a biopsy of the olecranon bursa revealed granulomatous inflammation. He was diagnosed with paucibacillary leprosy with neuritis. He responded well to multidrug therapy and prednisolone; his symptoms resolved over a few weeks. This case illustrates the challenges in diagnosing a case of leprosy with atypical presentation in a non\u2010endemic country.<\/jats:p>","DOI":"10.1111\/1756-185x.12916","type":"journal-article","created":{"date-parts":[[2016,7,26]],"date-time":"2016-07-26T07:16:54Z","timestamp":1469517414000},"page":"1035-1038","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Leprae reaction resembling rheumatologic disease as presenting feature of leprosy"],"prefix":"10.1111","volume":"19","author":[{"given":"Hazlyna","family":"Baharuddin","sequence":"first","affiliation":[{"name":"Faculty of Medicine Universiti Teknologi MARA Batu Caves Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarita","family":"Taib","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Universiti Teknologi MARA Batu Caves Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mollyza Mohd","family":"Zain","sequence":"additional","affiliation":[{"name":"Rheumatology Division Hospital Selayang Batu Caves Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shereen","family":"Ch'ng","sequence":"additional","affiliation":[{"name":"Rheumatology Division Hospital Selayang Batu Caves Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,7,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldl010"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0365-05962008000100010"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.47276\/lr.79.4.372"},{"key":"e_1_2_7_5_1","unstructured":"World Health Organization.Global leprosy situation (2012) Weekly Epidemiol Rec. Available from:http:\/\/www.who.int\/lep\/situation\/prevalence\/en\/ accessed on November 15 2015."},{"key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"170","DOI":"10.47276\/lr.85.3.170","article-title":"Leprosy \u2013 An imported Disease","volume":"85","author":"Kwan Z","year":"2014","journal-title":"Lepr Rev"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1756-185X.2012.01819.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2010.07.001"},{"key":"e_1_2_7_9_1","first-page":"76","article-title":"A study of rheumatological manifestations of leprosy","volume":"70","author":"Vengadakrishnan K","year":"2004","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0973-3698(11)60025-3"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/94.4.207"}],"container-title":["International Journal of Rheumatic Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1756-185X.12916","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185X.12916","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T14:34:13Z","timestamp":1695738853000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1756-185X.12916"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,26]]},"references-count":10,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2016,10]]}},"alternative-id":["10.1111\/1756-185X.12916"],"URL":"https:\/\/doi.org\/10.1111\/1756-185x.12916","archive":["Portico"],"relation":{},"ISSN":["1756-1841","1756-185X"],"issn-type":[{"value":"1756-1841","type":"print"},{"value":"1756-185X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,26]]},"assertion":[{"value":"2016-07-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}