Hansen's disease (HD): unusual presentations

Although leprosy has well defined clinical presentations which make early diagnosis possible, and curable treatment instituted promptly, new cases continue to emerge with unusual presentations which may lead to delayed diagnosis and treatment. This is a descriptive report of five patients. All the patients were seen at the Lagos University Teaching Hospital. The diagnosis was clinical and confirmed through pathology (skin-biopsy) and laboratory (peripheral smear) measures. Five patients with unusual presentations of mulitbacillary HD are described. One patient with apparently normal skin had non-healing and progressive episiotomy, colostomy and cystostomy wounds; the second patient had HD lesions co-existing with classical sarcoidal lesions; the third patient developed diffuse infiltration of the skin in the puerperium; the fourth patient, a physician, with apparently normal skin asked to be screened because he was caring for his father who had HD; and the fifth patient had halo nevi (Sutton's nevi) on the sites of erythema nodosum leprosum. The clinical presentations of HD seem inexhaustible. Unusual presentations continue to occur and there is need for sustained awareness of this serious but curable disease if diagnosed early. Nigerian Medical Practitioner Vol. 49(1&2) 2006: 14-1