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A 40-year male lepromatous leprosy patient presented with four, slightly erythematous patches, with multiple urticaria-like wheals, distributed over the body symmetrically and with thickened right ulnar and right common peroneal nerves. He was previously diagnosed as a case of chronic idiopathic urticaria. Slit skin smear from the patches and urticarial wheals showed a BI of 3+ and skin biopsy showed some features of borderline lepromatous leprosy (BL).
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