Pure Neuritic Leprosy Masquerading as Diabetic Neuropathy: A Diagnostic Challenge

Diabetes mellitus is a well-recognized cause of peripheral neuropathy, often presenting with numbness, paresthesia, and distal limb weakness.However, this common attribution can obscure the diagnosis of more insidious conditions, especially in regions where diseases like leprosy are endemic.Here, we report the case of a 50-year-old woman with longstanding, poorly controlled diabetes mellitus who presented with chronic numbness, distal limb weakness, and a non-healing digital ulcer.Initially suspected to have diabetic neuropathy, further clinical evaluation and histopathological confirmation revealed a diagnosis of pure neuritic type leprosy, a rare and often overlooked form of Hansen's disease.This case emphasizes the necessity of considering alternative diagnoses, including infectious etiologies, when neuropathic symptoms persist despite standard management, particularly in endemic regions.Early identification and appropriate intervention can significantly alter the disease trajectory, prevent irreversible nerve damage, and improve the quality of life.