Abstract

SERPENTINE LESION ON THE LEG; ANOTHER FACE OF HANSEN???S DISEASE

Author(s): B. M. Manjunath1, Shifa Sheikh2

ABSTRACT
Leprosy has been labelled as a disease with many faces since the time immemorial. This is mainly because of wide range of its clinical presentations depending upon the immune status of the individual. Leprosy is a disease of declining global endemicity, but is still an important healthcare problem in India.
Here, we report a case of leprosy with atypical presentation, which was later diagnosed as leprosy when investigated.
BACKGROUND
Leprosy is a chronic mycobacterial granulomatous disease caused by mycobacterium leprae affecting peripheral nerves, skin and certain other tissues.1
Depending upon the immune status of the individual, patients suffering from leprosy exhibit a wide spectrum of presentations ranging from tuberculoid to lepromatous type and immunologically unstable borderline forms in between.2,3
Leprosy can be diagnosed fairly accurately on the basis of three signs, which include hypoesthesia, skin lesions and thickened nerves.4
The uncommon disease presentations include localised lepromatous disease presenting with single nodule or localised area of papules and nodules, histoid leprosy, lucio leprosy and spontaneous ulcerations in longstanding untreated lepromatous leprosy. Uncommon presentations are hard to diagnose clinically. Histopathological examination becomes necessary in such circumstances for confirmatory diagnosis.5
We here present a case of Hansen’s disease with an unusual clinical presentation where histopathology was the key in establishing correct diagnosis.