Indian doctors initially thought their patient might have dyshidrotic eczema, bullous pemphigoid or another autoimmune disease based on her fluid-filled lesions. 

However, recurrent inflammation, polyarthritis and neuropathy raised their suspicions of an atypical bullous type 2 lepra reaction, leading to the eventual diagnosis of leprosy — or Hansen’s disease. 

The 42-year-old patient presented with a year-long history of disseminated, fluid-filled bullous lesions, mostly on her palms and soles. 

The lesions would intermittently worsen, coinciding with low-grade fever and diffuse myalgia, yet they would also spontaneously heal, the doctors said.