Revisiting hansen's disease: Recognizing the many neurodermatologic faces and its diagnostic challenges

• Main Authors: Bhaskara P Shelley, Manjunath Mala Shenoy
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Archives of Medicine and Health Sciences
• Subjects: Armadillo model; chameleons; Hansen's disease; high-resolution ultrasonography; leprae reactions; leprosy; mimics; neurobiology; pure neuritic leprosy; Schwann cells; small fiber neuropathy; temperature-linked pattern
• Online Access: http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=157;epage=170;aulast=Shelley

Hansen's disease (HD) looms still as a public health problem. Conventional wisdom and teaching largely view HD as a predominantly dermatologic disorder with much emphasis in the dermatology postgraduate curriculum. This review attempts to reorient this view and reemphasize that HD has primarily neurologic underpinnings since Mycobacterium leprae is an intracellular neurotropic bacterium. The main thrust of this article would, therefore, be a neurologist's perspective of HD. The cutaneous manifestations of HD are the sequelae of the neurobiology of M. leprae, its selective predilection to human Schwann cells, neurovascular bundle and its localization in the intracutaneous nerve plexus of the skin. We discuss the nuances of HD as a “great imitator,” the many faces of its neurodermatologic clinical presentation, the neurologic basis of HD clinical examination, and its diagnostic and therapeutic challenges.