{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T17:50:55Z","timestamp":1757613055438,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2022,10,26]]},"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:p>Leprosy is a chronic granulomatous infection caused by <jats:italic>Mycobacterium leprae<\/jats:italic> complex, causing skin and nerve lesions with potential for permanent disability. Leprosy can be overlooked in Western settings, as it is more prevalent in low-income and middle-income countries. We describe a 38-year-old woman with a 4-year history of progressive numbness of the left hand incorrectly diagnosed as multifocal acquired demyelinating sensory and motor neuropathy on the basis of clinical and neurophysiological findings. Treatment with empirical weekly corticosteroid followed by intravenous immunoglobulin resulted in the sudden development of a widespread rash; we then diagnosed borderline lepromatous leprosy on skin biopsy. We postulate that the immune treatments induced a temporary state of immune tolerance followed by a rebound of a T cell-mediated immune response resulting in a type 1 immunological response.<\/jats:p>","DOI":"10.1136\/pn-2022-003541","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T14:59:02Z","timestamp":1669388342000},"page":"71-73","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Leprosy rash precipitated by immunotherapy for suspected inflammatory neuropathy"],"prefix":"10.1136","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1196-4580","authenticated-orcid":false,"given":"Almond","family":"Leung","sequence":"first","affiliation":[{"name":"Department of Medicine and Neurology, Southern District Health Board, Dunedin, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan John","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Medicine, Southern District Health Board, Dunedin, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy Oliver","family":"Hodgson","sequence":"additional","affiliation":[{"name":"Southern Community Laboratories, Dunedin, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas John","family":"Cutfield","sequence":"additional","affiliation":[{"name":"Department of Medicine and Neurology, Southern District Health Board, Dunedin, New Zealand"},{"name":"University of Otago, Dunedin, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,11,25]]},"reference":[{"key":"2025090410560638000_23.1.71.1","first-page":"417","article-title":"Global leprosy (Hansen disease) update, 2019: time to step-up prevention initiatives","volume":"95","year":"2020","journal-title":"WER"},{"key":"2025090410560638000_23.1.71.2","unstructured":"New Zealand Ministry of Health . 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