Cardinal Signs & Symptoms
Delayed diagnosis of Hansen's disease (leprosy) can have
serious neurological consequences. The typical skin lesions and classic
neuropathy of leprosy are readily
recognized in countries
where the disease is more common, but in the U.S., where leprosy is rare, it can be difficult to diagnose. Physician awareness is key to the early diagnosis and treatment that can prevent disability.
Consider the diagnosis of leprosy when ...
Patient presents with non-responsive skin lesion and is
- Immigrant from country with high incidence of leprosy
- U.S. resident with history of foreign travel
- Resident of Texas or Louisiana
- Has referral history of multiple physician/specialist and/or frequent emergency room visits
Cardinal Signs
- Localized skin lesions
- Raised or flat
- Light or pigmented
- Sensory loss in lesion
- Thickened peripheral nerves
- Demonstrated acid-fact bacilli
in lesion
Laboratory Tests
- There are no serological or skin tests.
-
Skin biopsy needed for definitive diagnosis. More about skin biopsy
- PCR for M. leprae DNA may be needed in special circumstances
Patients with Delayed Diagnosis
Because of a delay in diagnosis patients may present for diagnosis of Hansen's disease who are already undergoing an acute with Reversal or ENL reaction:
- Acute, immunological complications may confuse clinical picture
- Acute inflammation of lesions
- Neuritis
- Arthritis
- Acral edema
- Such patients often have seen other
specialists before dermatologist referral
Seek prompt consultation with National Hansen's Disease Program. Phone 1-800-642-2477, weekdays 9 am to 5:30 pm ET (in Hawaii: 1-808-733-9831). |