When Pain is Beyond Biology - A Case of Fake Leprosy

Background: Pain is a complex phenomenon that implies pathophysiological processes and psychosocial components. A 56-year-old female patient complaining of pain and presenting with multiple mild physical signs was examined by a multidisciplinary team from the Ear-Nose-Throat, Dermatology, Hematology, General Clinics, and Psychiatry and Psychology Departments. Objective: To present a significant case where pain is primarily caused by psychological conflicts. Method: A multidisciplinary approach, with medical and psychological interventions. Results: The patient was deeply convinced; she had been contaminated by leprosy. Her enrooted personal beliefs, including religion and moral conflicts, seem to be the primary cause for her putative ‘disease’, a condition that was not confirmed by exhaustive exams. Conclusion: Pain normally is related to several factors, including biological, psychological and cultural. Some complex cases should be investigated by a multidisciplinary team of specialists, in order to identify extra-physiological components.