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Leprosy is still a largely worldwide spread disease but rarely encountered in metropolitan France. Its identification implies a multidisciplinary clinical, pathological and bacteriological diagnosis which is necessary to an efficient antibiotic treatment against a crippling disease which remains curable. Here we report the case of a 24-year-old man who was showing an original both cutaneous and pulmonary presence of acido-alcooloresistant bacillus which have been identified as Mycobacterium leprae by polymerase chain reaction (PCR). This unusual presentation of a cutaneous and pulmonary leprosy raises the problem of its differential diagnoses, including those of non-tuberculosis mycobacterial infections.