case_images: PMC11384573_01
case_images: Patient clinical photos and related examination results. (A-C)
  Mycobacterium leprae infection in a 39-year-old man (before treatment, China). (A) invasive erythema, papule could be seen on the upper extremities, with unclear boundaries. (B, C) erythema was symmetrically distributed on the hip and pelma. (D-F) Hematoxylin and eosin staining and acid-fast staining of the pelma. (D, E) Excessive keratosis, a large number of virchow cells in the dermis were banded and clumpy infiltrated, accompanied by a varying number of lymphocytes. (F) A large number of acid-fast bacilli could be seen. (G) Nested PCR result of the patient's blood sample. (H) Nested PCR result of the patient's skin lesion sample. N, negative control; P, positive control; O, other people's samples, not relevant to this case report; B, blood sample; S, skin lesion sample. DNA Marker: 100, 300, 500, 700, 900, 1200 bp, with 700 bp as reference; folp, gyrA and rpoB were around 300bp in the gel.
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case_images: Physical examination revealed diffuse cutaneous infiltration throughout the body (particularly on the limbs), along with symmetrically distributed brown patches on both buttocks, lower limbs, and palms ( Figures 1A-C ). Additionally, lymphocytes were observed in the dermis, while acid-fast staining revealed a significant presence of bacilli ( Figures 1D-F ). PCR, the results showed that all three targets were positive ( Figures 1G, H ). Primer sequences for three target genes are shown in  Supplementary Table 4 . Color Doppler ultrasound examination indicated edema and thickening of the right common peroneal nerve at the upper edge of the popliteal fossa ( Supplementary Figure 1 ).
case_images: Patient clinical photos after treatment and disease timeline. (A-C) The recovery of skin lesions after treatment. (D) Patient's illness timeline.
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case_images: After 13 months, the patient's symptoms resolved and the lesions subsided ( Figures 2A-C ). The timeline of the patient's illness is shown in the  Figure 2D .