A multi-scale computational fluid dynamics analysis of wind turbine blade leading edge erosion is presented. The test case is a large set of eroded blade sections. These are obtained by fitting the resolved eroded leading edge geometry of the outboard part of a multi-megawatt offshore wind turbine to the NACA633-618 airfoil. The erosion geometry measured by a blade laser scan is geometrically resolved in the aerodynamic simulations, whereas the aerodynamic effects of unresolved lower-amplitude scales are accounted for by using distributed surface roughness models. The simulations also account for the laminar-to-turbulent transition of the blade boundary layers with and without distributed roughness. An existing semi-empirical model and simulations of the nominal airfoil enable one to estimate the roughness level needed to trip leading edge boundary layer transition at the considered Reynolds number of 9 million. It is found that a) the mean roughness heights of the observed geometry perturbations are well above the critical roughness height, and b) consideration of either large or small erosion scales in isolation results in underestimating the airfoil performance impairment.