A 65-year-old farmer residing in Gougui (Kobeni/Hodh El Gharbi region), Mauritania, consulted on December 2, 2016, at the Aioun Regional Hospital for maculopapular, nodular lesions associated with chest pain and chronic productive cough. On admission to hospital, the skin signs had evolved over the past ten years, at first consisting of lichenoid lesions and multiple hypopigmented papules. A few months before consultation, a productive cough associated with progressive deterioration of the general condition occurred. There was no history of tuberculosis. Various analgesics, antibiotics, and topical treatment, including traditional medicines, had not improved his condition. The physical examination revealed the presence of diffuse hypopigmented lichenoid lesions varying from 2 to 5 cm in diameter at the base of the nose with sensory loss. Visual examination was normal. Auscultation revealed rales over the right bronchus. Sputum examination and Ziehl-Neelsen skin smears were negative. Skin biopsy was not performed due to inadequate medical facilities. HIV serology was negative. Laboratory examinations showed anemia (9 g/dl hemoglobin), normal blood sugar, and normal renal and hepatic functions. The chest X-ray showed reticulonodular infiltrates at the right lung apex and bilateral hilar lymphadenopathy (Figure 4). The diagnosis of lepromatous leprosy with concomitant disseminated tuberculosis was made. Antileprosy and antituberculosis treatment (rifampicin 600 mg/day, dapsone 100 mg/day, and clofazimine 100 mg/day) was initiated and was generally well tolerated, leading to a favorable response.