Case summary A 62 year old gentleman was admitted to medical ward for 2 months history of generalized body weakness, anorexia, vague abdominal pain, fatigue and multiple erythematous, non-pruritic, scaly patches and plaques scattered throughout his body associated with nasal stuffiness. These lesions were hypoaesthetic. Blood investigations revealed a high corrected calcium level at 3.24 mmol/L which explained his acute medical complaints. Slit skin smear revealed Bacteriological Index (BI) of 1.2 and Morphological Index (MI) of 3.9. Skin biopsy confirmed the diagnosis of Borderline Lepromatous Leprosy. Institution of systemic steroids, vigorous intravenous fluid infusion and the implementation of multi-drug therapy for his leprosy resulted in a relatively swift decrease in reduction of calcium level. Conclusion This case report highlights the rare but important association of hypercalcaemia with leprosy. However, other granulomatous diseases such as sarcoidosis and tuberculosis have higher association with hypercalcaemia.

Background Leprosy is often complicated by deformities, disabilities and intermittent hypersensitivity reactions. In the course of management, the physical impact of this disease is often assessed thoroughly but its psychological impact and quality of life is often left unaddressed. Objective To assess the effect of leprosy on the quality of life (QOL) among our patients. Methods This cross sectional study was conducted on patients diagnosed with leprosy in Kuala Lumpur Hospital. The patients were interviewed using World Health Organization Quality of Life Assessment - abbreviated version (WHOQOL-BREF) questionnaire which consists of 26 questions exploring four domains: physical, psychological, social relationships and environmental. Patient’s perception towards diagnosis was also assessed. Results Out of the 26 respondents, 19 (73.1%) were males and 7 females with the mean age of 41 years. 84.6% were of Malay descent and 14 (53.8%) patients were foreigners. Twenty three patients (88.5%) were diagnosed multibacillary and 3 (11.5%) had paucibacillary leprosy. Mean QOL scores by domains were: physical 13.0, psychological 12.5, social relationships 13.4 and environmental 14.2. The mean total QOL score among males were 52.9 and 54 for females but the difference was not statistically significant. Fear was the commonest reaction to initial diagnosis. Conclusion Quality of life is reduced among our patients with leprosy. Early detection and treatment can prevent deformities and disabilities but the importance of incorporating counselling and patient education in overall management cannot be overemphasized.