{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:12:49Z","timestamp":1789560769718,"version":"build-2803163510"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 2","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Leprosy primarily affects the skin and peripheral nerves, with neuropathy usually accompanying skin lesions. Rarely, neural involvement may precede cutaneous manifestations, leading to diagnostic delay. We report the case of a 36-year-old male presenting with bilateral lower limb sensory motor neuropathy initially attributed to Vitamin B12 deficiency. Despite normalization of B12 levels, symptoms persisted, and subsequent skin changes led to biopsy confirmation of borderline tuberculoid leprosy. This case emphasizes considering Hansen\u2019s disease in patients with unexplained neuropathy, particularly in the endemic regions, even before overt skin lesions appear.<\/jats:p>","DOI":"10.4103\/aam.aam_74_26","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T07:06:06Z","timestamp":1775545566000},"page":"S356-S358","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Bilateral Lower Limb Sensory Motor Neuropathy as the Initial Manifestation of Borderline Tuberculoid Leprosy: A Diagnostic Challenge"],"prefix":"10.4103","volume":"25","author":[{"given":"Bysani Nikhil","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of General Medicine, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohini","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"R2-20260916","first-page":"2964 6","article-title":"Rapid identification of mycobacterium leprae by polymerase chain reaction restriction fragment length polymorphism analysis of the heat shock protein 65 gene from skin specimens","volume":"128","author":"Zhao","year":"2015","journal-title":"Chin Med J (Engl)"},{"key":"R3-20260916","first-page":"3","article-title":"Neuritic leprosy: The silent presentation","volume":"71","author":"Walker","year":"2000","journal-title":"Lepr Rev"},{"key":"R4-20260916","first-page":"451","article-title":"Histological classification and the immunological spectrum of leprosy","volume":"51","author":"Ridley","year":"1974","journal-title":"Bull World Health Organ"},{"key":"R5-20260916","doi-asserted-by":"crossref","first-page":"2517","DOI":"10.2147\/CCID.S421159","article-title":"One case of tuberculosis like leprosy with a type I leprosy reaction","volume":"16","author":"Li","year":"2023","journal-title":"Clin Cosmet Investig Dermatol"},{"key":"R6-20260916","first-page":"233","article-title":"Neuropathy in Hansen's disease: Clinical, electrophysiological, and histopathological correlation","volume":"75","author":"Kumar","year":"2009","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"R7-20260916","doi-asserted-by":"crossref","first-page":"117288","DOI":"10.1016\/j.jns.2020.117288","article-title":"Neuropathies of leprosy","volume":"420","author":"Khadilkar","year":"2021","journal-title":"J Neurol Sci"},{"key":"R8-20260916","doi-asserted-by":"crossref","first-page":"e2024096.v","DOI":"10.47276\/lr.95.4.2024096","article-title":"Late diagnosis of leprosy in the Netherlands: A medical anthropological study from a patient and healthcare provider perspective","volume":"95","author":"Ramdas","year":"2024","journal-title":"Lepr Rev"},{"key":"R9-20260916","first-page":"230","article-title":"Leprosy: Too complex a disease for a simple elimination paradigm","volume":"83","author":"Lockwood","year":"2005","journal-title":"Bull World Health Organ"},{"key":"R10-20260916","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1128\/CMR.19.2.338-381.2006","article-title":"The continuing challenges of leprosy","volume":"19","author":"Scollard","year":"2006","journal-title":"Clin Microbiol Rev"}],"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_74_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:00:40Z","timestamp":1789560040000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_74_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":9,"journal-issue":{"issue":"Suppl 2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/aam.aam_74_26","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]},"assertion":[{"value":"2026-01-24","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-10","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}