Mycobacterium leprae likes cool temperatures (FA2020 p141)

Mycobacterium leprae is an acid-fast bacteria which can cause two skin manifestations:

• Lepromatous presents diffusely over the skin and with leonine facies and is more serious with a largely Th2 response and high bacteria load
• Tuberculoid (what our patient has) presents with a few hypoesthetic hairless skin plaques with a largely Th1 response and low bacteria load

Leprosy likes cool temperatures so it infects skin and superficial nerves. Even without knowing the organism, the link could also be potentially inferred!