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Case Reports
. 2025 Mar 19;17(3):e80822.
doi: 10.7759/cureus.80822. eCollection 2025 Mar.

Leprosy Mimicking Thrombangiitis Obliterans (Buerger's Disease): A Case Study

Caio O Sena Sr  1 , Isabela Maria B Goulart  2 , Pâmella C Justino Sena  3 , Juliana C Justino Omar  1 , Bruno C Dornelas  1
Affiliations
Case Reports

Leprosy Mimicking Thrombangiitis Obliterans (Buerger's Disease): A Case Study

Caio O Sena Sr et al. Cureus. .

Abstract

Thromboangiitis obliterans (TAO), also known as Buerger's disease, is a vasculitis associated with a history of smoking, presenting as limb ischemia. Conversely, leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae). While leprosy typically presents with neurological signs, this report describes a rare case of atypical borderline lepromatous (BL) leprosy in a type 1 reaction with an initial presentation mimicking TAO in an elderly woman. This atypical presentation, combined with skin changes related to aging, masked the diagnosis of BL leprosy.

Keywords: borderline lepromatous leprosy; buerger's disease; mycobacterium leprae; thromboangiitis obliterans; vasculitis.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Research Ethics Committee Federal University of Uberlândia issued approval (77002924.9.0000.5152). Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Patient's follow-up over time (scale in months)
Month 0 corresponds to the worsening of symptoms that began five years ago. BI: bacillary index in skin biopsy; *Evaluation of physical disability according to the World Health Organization; BL: borderline lepromatous; G2: grade 2 (disability assessment); ROM: rifampicin, ofloxacin, minocycline; CT: cycle threshold. EI: enzyme-linked immunosorbent assay (ELISA) index; MBI: mean bacillary index in skin-slit smear; MDNAB: Mycobacterium leprae (M. leprae) DNA detection by quantitative polymerase chain reaction (qPCR) in blood; MDNASb: M. leprae DNA detection by qPCR in skin biopsy; MDNASs: M. leprae DNA detection by qPCR in skin-slit smear.
Figure 2
Figure 2. Borderline lepromatous leprosy in a type 1 reaction
A) Superficial skin sample with edema and mild mononuclear inflammatory infiltrate (H&E, 4x); B) Marked edema with sparse lymphocytes and foamy macrophages (H&E, 20x); C) In the deep reticular dermis, small aggregates of lymphocytes and foamy macrophages are observed (H&E, 40x); D) Solid and fragmented acid-fast bacilli within histiocytes and endothelial cells (*) (Faraco-Fite, 100x). Image credits: Bruno C. Dornelas and Caio O. Sena
See this image and copyright information in PMC

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