Photoclinic Diagnosis: Lepromatous leprosy

A 55-year-old man presented with a six month history of widespread pruritic plaques. He had been treated with several topical steroids, with a possible diagnosis of subacute dermatitis without any improvement. His medical history was unremarkable and he had no known contact with other people similarly affected. Physical examination revealed generalized erythematous in_ltrative plaques on his trunk and limbs. The plaques were non-tender and had normal sensation. No nerve enlargement or neurologic impairment was detected. He had no lymphadenopathy. Physical examination was otherwise normal. Routine hematological and biochemical investigations were within normal ranges. The chest X-ray was unremarkable.