Leprosy
Mailing List, September 12th, 2009
Ref.:
Leprosy eliminated?
From:
Schreuder Pieter AM, The Netherlands
Dear
Salvatore,
I
refer to Drs de Koning’s and Vijayakumaran’s comments (LML Sept.
11th and Aug. 27, 2009 respectively).
Even when there is a functioning primary health care and referral
system still some patients are only diagnosed very late. Multibacillary
(MB) Hansen’s disease (HD), especially close to the lepromatous end
of the spectrum, may mimic (many) other diseases, and the patient can
not be diagnosed without a biopsy or a slit-skin smear examination. Clinicians
(including dermatologists) working in a HD endemic area do not always
include HD in their differential diagnosis, especially when the
clinical presentation is unusual. HD
should be considered in all patients with skin lesions not responding
to treatment, especially when they have neurological deficits, and
live or have lived in an HD endemic area. Due to the increase in
global travel and immigration, doctors in low endemic areas need to
consider HD as a possible diagnosis.
Nery
JA, Schreuder PA, de Mattos PC, de Mendança LV, Tardi RT, de Mello S,
Azulay RD,
Lehman LF, Naafs B. Hansen’s
disease in a
general
hospital: uncommon presentations and delay in diagnosis. J Eur Acad
Dermatol Venereol, 2009; 23: 150-156.
Kind regards,
Pieter
AM Schreuder
