{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T21:29:58Z","timestamp":1773782998151,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":254,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Medicine"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    Leprosy, caused by\n                    <jats:italic>Mycobacterium leprae<\/jats:italic>\n                    , remains a significant public health concern in certain endemic regions, but it is rarely encountered in nonendemic areas, posing diagnostic challenges. This case report discusses an unusual presentation of lepromatous leprosy in a patient residing in Saudi Arabia with no history of travel to endemic regions. The patient\u2019s clinical features were atypical, lacking the classic neurological involvement and sensation loss commonly associated with leprosy. Definitive diagnosis was achieved through histopathological examination revealing diffuse histiocytic infiltrates, a grenz zone, and acid\u2010fast bacilli confirmed by modified Ziehl\u2013Neelsen staining. The patient responded well to multidrug therapy according to WHO guidelines. This case highlights the importance of maintaining high clinical suspicion, utilizing appropriate diagnostic techniques, and understanding the epidemiological complexities of leprosy in low\u2010prevalence settings. Strengthening awareness and surveillance is essential to prevent underdiagnosis and curb transmission in nonendemic regions.\n                  <\/jats:p>","DOI":"10.1155\/carm\/8232445","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:48:22Z","timestamp":1757702902000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Uncommon Presentation of Lepromatous Leprosy in a Nonendemic Setting: A Case Report"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0461-8775","authenticated-orcid":false,"given":"Mhdia Elhadi","family":"Osman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4245-0482","authenticated-orcid":false,"given":"Tareq Nafea","family":"Alharby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8168-5647","authenticated-orcid":false,"given":"Yasser","family":"Alhabeeb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8236-161X","authenticated-orcid":false,"given":"Ayman","family":"Elshenawy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7051-3329","authenticated-orcid":false,"given":"Hala Ghazi","family":"Alreshidi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0185-7297","authenticated-orcid":false,"given":"Saja Saleem","family":"Saja Saleem Alhayeti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9766-7585","authenticated-orcid":false,"given":"Areej Alhumaidi","family":"Alshammari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"e_1_2_10_1_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-019-2198-1"},{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa419"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/femspd\/fty062"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.inhe.2011.09.006"},{"key":"e_1_2_10_5_2","volume-title":"Interruption of Transmission and Elimination of Leprosy Disease","author":"World Health Organization","year":"2023"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.00567"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.4103\/2230-8210.152775"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.4103\/idoj.IDOJ_282_17"},{"key":"e_1_2_10_9_2","first-page":"39","article-title":"Leprosy (Hansen\u2019s Disease): An Update and Review","volume":"120","author":"Gilmore A.","year":"2023","journal-title":"Missouri Medicine"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.49954"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.47859"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s44197-025-00379-w"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/ddg.13301"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/20499361221135885"},{"key":"e_1_2_10_15_2","volume-title":"Guidelines for the Diagnosis, Treatment and Prevention of Leprosy","author":"World Health Organization","year":"2018"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2908.220367"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/20477724.2022.2057722"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1080\/21505594.2022.2141987"},{"key":"e_1_2_10_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2015.12.015"},{"key":"e_1_2_10_20_2","doi-asserted-by":"publisher","DOI":"10.25259\/JSSTD_34_2022"},{"key":"e_1_2_10_21_2","doi-asserted-by":"publisher","DOI":"10.20473\/bikk.V32.2.2020.149-157"},{"key":"e_1_2_10_22_2","first-page":"262","article-title":"Study of Serum Lipids in Leprosy","volume":"68","author":"Gupta A.","year":"2002","journal-title":"Indian Journal of Dermatology Venereology and Leprology"},{"key":"e_1_2_10_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2021.02.048"},{"key":"e_1_2_10_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2014.10.002"},{"key":"e_1_2_10_25_2","volume-title":"Lucio\u2019s Phenomenon in a Non-Endemic Region: A Case Report","author":"Yu A. 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