A 41-year-old man who had immigrated from Costa Rica 10 years prior presented with paresthesias in his hands and feet, loss of the eyebrows and eyelashes, and skin changes including mild erythema of the earlobes, fingers, and toes. He reported taking no medications. What would you do next?
A man had ulceration of the soles, legs, hands, elbows, and face; numbness of the hands and feet; diffuse infiltration of the face and madarosis of the lateral half of the eyebrows; and hypoaesthesia over the palms, proximal forearms, feet, and legs. What is your diagnosis?
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