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Leprosy is a chronic, progressive infectious disease caused by Mycobacterium leprae. It can present as two major polar forms (tuberculoid and lepromatous) and other intermediate variants. Mid-borderline leprosy represents the midpoint in the leprosy spectrum. The most astonishing part of leprosy is that it can present in ample ways making clinical diagnosis an enigma. Sometimes, an unusual presentation delays the diagnosis and management. In that case, histopathology comes to rescue in confirming the daignosis.

A case of lepromatous leprosy presenting with punched out infiltrated plaques, a diagnostic enigma