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All Journal Sumatera Medical Journal
Surender Benedict
Pekan District Health Office, Jalan Haji Montok, Pekan, 26600, Malaysia
Immunology & microbiology Medicine & Pharmacology

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Late Detection with Claw Hand Deformity in a Leprosy Person: A Case Report Surender Benedict; Zulkifli Harun
Sumatera Medical Journal Vol. 9 No. 1 (2026): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/sumej.v9i1.20279

Abstract

Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae. It remains a major public health problem and is often neglected, especially in remote communities. Objective: This case report describes a patient with late detection of multibacillary leprosy who presented with advanced deformity, and highlights the factors contributing to delayed diagnosis. Methods: A clinical assessment and detailed history were conducted on a 78-year-old man from the Orang Asli community in Pekan, Pahang. The diagnosis was made clinically and later confirmed through a skin slit smear with acid-fast staining. Disability grading was performed according to the World Health Organization criteria. Results: The patient presented with a left claw hand deformity that had progressed for two years without treatment, accompanied by ulceration and sensory loss. He was classified as having grade 2 deformity. Multidrug therapy (MDT) was started promptly at the primary care clinic, and his symptoms improved after treatment initiation. Stigma and low awareness of leprosy were identified as the main factors contributing to the delay in seeking care. Conclusion: This case illustrates the consequences of late detection of leprosy, which can lead to permanent disability. Early recognition and prompt initiation of MDT remain essential to prevent progression and reduce disability, especially in underserved communities.
Challenges in Diagnosing Leprosy Mimicking Tinea Versicolor Surender Benedict; Zulkifli Harun; Masri Quak Saifuddin
Sumatera Medical Journal Vol. 9 No. 2 (2026): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/sumej.v9i2.25140

Abstract

Background: Leprosy is a significant concern within the medical fraternity due to its enduring prevalence across various countries. It is frequently misdiagnosed due to its clinical presentation, which can closely resemble that of tinea versicolor. Objective: This case report highlights a 26-year-old Orang Asli woman from Pekan, Pahang, who exhibited multiple hypopigmented lesions on her right flank for 1 year. Initially misdiagnosed as tinea versicolor by a general practitioner, her condition showed no improvement despite appropriate antifungal treatment. The patient’s history revealed close contact with persons with leprosy, and she resides in an endemic area. Methods: A clinical assessment was conducted, including medical history, contact history, and physical examination. A slit-skin smear was performed to establish the diagnosis. Results: A skin slit smear was performed, which yielded positive results and confirmed multibacillary leprosy. Consequently, multidrug therapy was promptly initiated in the primary care clinic. The lesions improved, indicating a positive response to multidrug therapy (MDT). Conclusion: This case underscores the critical importance of maintaining a high index of suspicion for leprosy in endemic regions, particularly when patients present with lesions that may masquerade as other dermatological conditions.
Co-Authors Masri Quak Saifuddin Zulkifli Harun