45-year-female- old had fatigue,abdominalpain,skin xerosis,papules on elbows.

labs exam :

- Hb:10,5 - cpk and other routin blood tests are within normal range .

-abdomin,s echo , and chest-x ray are  normal .

- in the first our diagnosis was eruptive xanthoma , and because aneamea and xerosis . we suggested hypothyroidism, but triglyceried , T3 , and TSH were normal .

-Zeil- nelson of nasal smear:++++

diagnosis ; leprosy