Hansen's Disease (Leprosy): Clinical Presentation and Diagnosis

Clinical Forms

Hansen's disease manifests in several clinical forms, including tuberculoid (paucibacillary), lepromatous (multibacillary), borderline (dimorphous), and indeterminate, based on the host's immune response to M. leprae, characterized by distinct skin lesions and nerve involvement 1, 3
The tuberculoid form is characterized by one or a few well-demarcated, hypopigmented, and anesthetic skin lesions with active spreading edges and clearing centers, and peripheral nerve swelling may occur 1, 3
The lepromatous form presents with multiple erythematous papules and nodules or infiltration of the face, hands, and feet with bilateral and symmetrical distribution that progresses to skin thickening 1, 3

Hansen's disease typically involves the skin, with various lesions depending on the disease form 1, 3
The upper respiratory mucosa can be involved, leading to nasal symptoms 1, 3

Diagnosis is confirmed by laboratory criteria, including demonstration of acid-fast bacilli in skin or dermal nerve, obtained from full-thickness skin biopsy of a lepromatous lesion 1, 3
Clinical presentation, including compatible signs and symptoms such as skin lesions and neurological findings, is also used to confirm diagnosis 1, 3