Leprosy is a rare chronic infectious disease that can be challenging to diagnose in non-endemic settings due to limited clinical experience among physicians and its marked clinical heterogeneity. We report the case of leprosy in a Nordic patient with an extensive travel history who presented with cutaneous lesions, nasal congestion, and peripheral neurological symptoms. Although the histopathological findings were not fully specific, modified Ziehl-Neelsen staining revealed numerous acid-fast bacilli within the tissue samples. Mycobacterium leprae was subsequently confirmed by molecular analyses. To minimise diagnostic delay and prevent disease progression, we provide an overview of the histopathological features of leprosy and discuss relevant differential diagnoses.