Leprosy presenting as orofacial pain: case report.

Area of Science:

• Neurology
• Infectious Diseases
• Dermatology

Background:

• Neuropathic orofacial pain presents diagnostic challenges.
• Leprosy (Hansen's disease) is a chronic infectious disease primarily affecting peripheral nerves.

Observation:

• An unusual case of neuropathic orofacial pain secondary to leprosy is presented.
• The patient, who migrated from India, initially presented with symptoms mimicking dental pain and temporomandibular disorder.
• The correct diagnosis of leprosy was delayed despite the patient having lived in Australia for 24 years.

Findings:

• The trigeminal nerve is often involved in leprosy, typically causing sensory loss.
• This case is the first in Western literature where leprosy presented primarily as neuropathic orofacial pain, initially misdiagnosed.
• Leprosy can manifest years after migration from endemic regions, even in immunocompetent individuals.

Implications:

• Clinicians should consider leprosy in the differential diagnosis of neuropathic orofacial pain, particularly in patients with a history of travel or migration from leprosy-endemic areas.
• Early recognition of leprosy is crucial to prevent further neurological damage and ensure appropriate treatment.
• This case underscores the importance of a comprehensive diagnostic approach for persistent orofacial pain.