Lepromatous Leprosy in an Immunosuppressed Patient Due to Renal Transplantation Associated with Glucose-6-Phosphate Dehydrogenase Deficiency: A Diagnostic and Therapeutic Challenge

Abstract

Lepromatous Leprosy; Renal Transplantation; Immunosuppressed Patient

Lepra lepromatosa; Trasplante renal; Paciente inmunodeprimido

Lepra lepromatosa; Trasplantament renal; Pacient immunosupressor

Leprosy, declared “eliminated” by WHO in 2000, persists globally with 165,459 cases recorded in 2022.[1] Leprosy in solid organ transplant recipients remains rare, with a few documented examples.[2,3] This case report explores the complex challenges in diagnosing and treating leprosy in solid organ transplantation, characterized by intricate polypharmacological treatments and immunomodulatory drugs. A 56-year-old male, originally from Senegal but residing in Spain since 1996, presented to the dermatology department in november 2022 with multiple elastic nodules on his upper extremities and face [Figure 1]. These lesions persisted for two months without accompanying symptoms or loss of thermosensory sensitivity. The patient had a kidney transplant in 2014 due to interstitial nephropathy, necessitating ongoing immunosuppression with tacrolimus and sirolimus.