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Arch Neurol. 2002;59:306.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A 37-YEAR-OLD woman, a native of Cape Verde Islands who lived in Italy for 13 years, had an indolent perforating ulcer on her left big toe as her only complaint (Figure 1, A). Her deceased father had reportedly been affected by leprosy. On examination, muscle power and tendon reflexes were normal, but there was severe loss of pain and temperature sensation and moderate loss of light touch sensation in the 4 limbs (Figure 1, B). Electrophysiologic studies documented a distal polyneuropathy, with a severe involvement of sensory fibers and a moderate involvement of motor fibers. Autonomic dysfunction was represented by anhidrosis in the 4 limbs, where sudomotor skin responses were also absent. Radiographs of the left foot showed acute osteomyelitis in the first phalanx of the hallux, underlying the skin lesion. The presence of acid-fast bacilli was demonstrated in a skin biopsy processed by the Wade . . . [Full Text of this Article]

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