An Ohio patient, without recent international travel, presented with Hansen's disease, an infection rarely seen in the US. The diagnosis of Mycobacterium leprae was confirmed through skin biopsy showing granulomatous inflammation with acid-fast bacilli and positive PCR. The patient exhibited classic symptoms of skin lesions and peripheral nerve involvement. Successful treatment was achieved using a monthly regimen of rifampin, minocycline, and moxifloxacin. This case highlights the importance of considering Hansen's disease even in non-endemic areas and in patients without typical exposure history, emphasizing the diagnostic value of histopathology and PCR for atypical presentations.
Key note: Hansen's disease should be considered in unusual dermatological or neurological presentations, even without travel history.