ABSTRACT
Leprosy has many unique manifestations, sometimes delaying the actual diagnosis. Arthitis in leprosy is a common rheumatologic manifestation seen in lepra reactions. Diffuse fusiform digital swelling termed as dactylitis may occur secondary to leprosy arthritis and enthesitis. These presentations are common in other rheumatologic disorders and may cause diagnostic dialemma till neurologic manifestations of leprosy are evident. We present a case of lepromatous leprosy in an Indian patient manifesting as pseudodactylitis and nodular lesions over forehead. On examination he had enlarged peripheral nerves and sensory loss over distal limbs. Slit skin smear was positive for lepra bacilli and patient was treated with WHO - MDT multibacillary regimen. This report highlights the unique manifestation of lepromatous leprosy which requires a high index of suspicion for diagnosis.