Leprosy is a disease known since ancient times. It is caused by Mycobacterium leprae. The skin, peripheral nerves, eyes, and mucous membranes of the upper respiratory tract are especially affected. Lepromatous leprosy is a clinical entity that has become rare worldwide today with the introduction of polydrug therapy, resulting in a dramatic decline in overall prevalence. In epidemic settings, atypical manifestations should be known because they are a source of disease transmission. Lepromatous leprosy rarely occurs as part of an immune deficiency. We report a case of diffuse leprosy in an HIV-positive patient.