Kedir Negesso Tukeni ^1,2* Tadele Molla Aga ² Tamirat Godebo Woyimo ² Abdo Abafogi ² Eyob Tarekegn Biru ² Idosa Taso Mamo ² Elias Ababulgu Abadiko ² Esayas Kebede Gudina ²

• ¹ Department of Internal Medicine, Jimma University, Jimma, Ethiopia
• ² Jimma University, Jimma, Oromia, Ethiopia

Leprosy remains a significant public health concern in Ethiopia, with challenges in timely diagnosis and management contributing to disabilities. This case report details a 15-yearold male who presented with diffuse nodular and bullous skin lesions, peripheral neuropathy, and systemic symptoms, ultimately diagnosed with multibacillary leprosy confirmed by a positive skin smear for acid-fast bacilli. A 15-year-old immunocompetent male presented to emergency department with a 2-week history of diffuse, non-pruritic skin lesion, joint swelling, numbness and tingling sensation. The patient was febrile on arrival. Physical examination revealed erythematous nodular skin lesion over the face and hand bilaterally, non-blanching bullous lesion over the right. The left hand was swollen and tender to touch, with superficial collection, suggestive of abscess. There was also hypopigmented skin lesion over the medial aspect of the left leg and thigh bilaterally with loss of sensation. There was bilateral ulnar and radial nerve enlargement, saddle nose and tenderness at olecranon. The skin smear was positive for acid-fast bacilli. The patient was treated initially with corticosteroids and antibiotics, followed by referral for multidrug therapy and was advised for further follow up for treatment response. The case describes the critical role of early recognition and multidisciplinary management in leprosy, particularly in endemic areas. The complexity of presentation demonstrates the need for ongoing vigilance among healthcare providers. Public health initiatives aimed at improving diagnostic capabilities and expanding leprosy services are vital for reducing the disease burden in countries like Ethiopia.