Images in Clinical Tropical Medicine Borderline Lepromatous Leprosy in an Italian Man

right eye with decreased vision (Figure 1A) and multiple asymptomatic erythematous infiltrated nodules and edema-tous plaques on the face (Figure 1B), tongue (Figure 1C), and trunk and extremities (Figure 1D). Lesions appeared on his face 20 years ago and progressively enlarged and diffused on the trunk. Two of his relatives had been affected by lepromatous leprosy. A skin biopsy specimen showed a diffuse infiltrate of vacuolar macrophages engulfed with mycobacteria (Figure 1E) and the focal presence in the dermis of few multinucleated giant cells and a focal infiltrate of neutrophils. A polymerase chain reaction identified Mycobacterium leprae. Mycobacteria were confirmed by multiple skin smears stained with Ziehl-Neelsen stain. An ophthalmologic consul-tation diagnosed acute right uveitis. A neurologic consulta