Leprosy: an unexpected presentation

A case of a 70 years-old Kuwaiti woman was presented with severe epistaxis. Physical examination was unremarkable for skin lesions or facial deformities. Nasal examination revealed nasal hypoalgesia and bleeding from a localized mass. Histological examination of the excised mass revealed granuloma and modified Zeil-Nelson stain confirmed the presence of mycobacterium leprae. In this patient, nasal hypoalgesia, epistaxis, and the localized nasal granuloma were the only manifestations of an active infectious disease