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Leprosy
Lauren M. Ladd, MD; B. J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Hansen disease
            • Definitions

              • Chronic infection caused by Mycobacterium leprae
                • Initial infection of skin and nerves causes cellular immune response resulting in discolored, aesthetic skin patches and nerve injury
                • Secondary peripheral neuropathy → repetitive trauma with superimposed skin ulcerations, neuropathic joint changes, ± superimposed bacterial infections

            IMAGING

            • General Features

              • Radiographic Findings

                • MR Findings

                  • Ultrasonographic Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • Staging, Grading, & Classification

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  Selected References

                                  1. Gunawan H et al: Leprosy-related chronic arthritis with an abundance of Mycobacterium leprae in the synovial fluid: a rare case. Int Med Case Rep J. 14:371-6, 2021
                                  2. Bandeira SS et al: Leprosy reactions in childhood: a prospective cohort study in the Brazilian Amazon. Infect Drug Resist. 12:3249-57, 2019
                                  3. Nery JA et al: Understanding the type 1 reactional state for early diagnosis and treatment: a way to avoid disability in leprosy. An Bras Dermatol. 88(5):787-92, 2013
                                  4. Jain S et al: High-resolution sonography: a new technique to detect nerve damage in leprosy. PLoS Negl Trop Dis. 3(8):e498, 2009
                                  5. Slim FJ et al: The potential role of magnetic resonance imaging in patients with Hansen's neuropathy of the feet: a preliminary communication. Int J Low Extrem Wounds. 8(3):169-73, 2009
                                  6. Worobec SM: Treatment of leprosy/Hansen's disease in the early 21st century. Dermatol Ther. 22(6):518-37, 2009
                                  7. Luyckx G et al: Exotic pathology of the hand and foot. A pictorial review. JBR-BTR. 91(4):160-5, 2008
                                  8. Slim FJ et al: A clinical and radiological follow-up study in leprosy patients with asymptomatic neuropathic feet. Lepr Rev. 79(2):183-92, 2008
                                  9. Hari S et al: Magnetic resonance imaging of ulnar nerve abscess in leprosy: a case report. Lepr Rev. 2007 Jun;78(2):155-9. Erratum in: Lepr Rev. 78(4):434, 2007
                                  10. Ribeiro FB et al: Evaluation of bone and mineral metabolism in patients recently diagnosed with leprosy. Am J Med Sci. 334(5):322-6, 2007
                                  11. Maas M et al: MR imaging of neuropathic feet in leprosy patients with suspected osteomyelitis. Int J Lepr Other Mycobact Dis. 70(2):97-103, 2002
                                  12. Maas M et al: MRI in clinically asymptomatic neuropathic leprosy feet: a baseline study. Int J Lepr Other Mycobact Dis. 69(3):219-24, 2001
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Pathology

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Synonyms

                                              • Hansen disease
                                            • Definitions

                                              • Chronic infection caused by Mycobacterium leprae
                                                • Initial infection of skin and nerves causes cellular immune response resulting in discolored, aesthetic skin patches and nerve injury
                                                • Secondary peripheral neuropathy → repetitive trauma with superimposed skin ulcerations, neuropathic joint changes, ± superimposed bacterial infections

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • MR Findings

                                                  • Ultrasonographic Findings

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • Staging, Grading, & Classification

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Demographics

                                                            • Natural History & Prognosis

                                                              • Treatment

                                                                DIAGNOSTIC CHECKLIST

                                                                • Consider

                                                                  Selected References

                                                                  1. Gunawan H et al: Leprosy-related chronic arthritis with an abundance of Mycobacterium leprae in the synovial fluid: a rare case. Int Med Case Rep J. 14:371-6, 2021
                                                                  2. Bandeira SS et al: Leprosy reactions in childhood: a prospective cohort study in the Brazilian Amazon. Infect Drug Resist. 12:3249-57, 2019
                                                                  3. Nery JA et al: Understanding the type 1 reactional state for early diagnosis and treatment: a way to avoid disability in leprosy. An Bras Dermatol. 88(5):787-92, 2013
                                                                  4. Jain S et al: High-resolution sonography: a new technique to detect nerve damage in leprosy. PLoS Negl Trop Dis. 3(8):e498, 2009
                                                                  5. Slim FJ et al: The potential role of magnetic resonance imaging in patients with Hansen's neuropathy of the feet: a preliminary communication. Int J Low Extrem Wounds. 8(3):169-73, 2009
                                                                  6. Worobec SM: Treatment of leprosy/Hansen's disease in the early 21st century. Dermatol Ther. 22(6):518-37, 2009
                                                                  7. Luyckx G et al: Exotic pathology of the hand and foot. A pictorial review. JBR-BTR. 91(4):160-5, 2008
                                                                  8. Slim FJ et al: A clinical and radiological follow-up study in leprosy patients with asymptomatic neuropathic feet. Lepr Rev. 79(2):183-92, 2008
                                                                  9. Hari S et al: Magnetic resonance imaging of ulnar nerve abscess in leprosy: a case report. Lepr Rev. 2007 Jun;78(2):155-9. Erratum in: Lepr Rev. 78(4):434, 2007
                                                                  10. Ribeiro FB et al: Evaluation of bone and mineral metabolism in patients recently diagnosed with leprosy. Am J Med Sci. 334(5):322-6, 2007
                                                                  11. Maas M et al: MR imaging of neuropathic feet in leprosy patients with suspected osteomyelitis. Int J Lepr Other Mycobact Dis. 70(2):97-103, 2002
                                                                  12. Maas M et al: MRI in clinically asymptomatic neuropathic leprosy feet: a baseline study. Int J Lepr Other Mycobact Dis. 69(3):219-24, 2001