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Hansen's disease update
1Department of Medicine, University of Florida/Shands Teaching Hospital, Gainesville.
Insights
Hansen's disease (leprosy) is increasing in the US, particularly in Florida, due to immigration. Early recognition and treatment are crucial to prevent severe complications.
Area of Science:
- Medical Science
- Infectious Diseases
- Dermatology
Background:
- The incidence of Hansen's disease (leprosy) is rising in the United States, with a notable increase in cases observed in California and Florida.
- This surge is primarily linked to the immigration of individuals from regions where Hansen's disease is endemic.
- Florida's significant immigrant population from Caribbean basin countries necessitates heightened physician awareness of this condition.
Purpose of the Study:
- To inform healthcare providers, especially in Florida, about the increasing incidence of Hansen's disease.
- To highlight the importance of recognizing early clinical manifestations of Hansen's disease.
- To emphasize the need for prompt diagnosis and treatment to prevent long-term sequelae.
Main Methods:
- Review of epidemiological trends and clinical presentations of Hansen's disease.
- Discussion of diagnostic considerations, including early asymptomatic signs and acute inflammatory reactions.
- Overview of current therapeutic agents and management strategies.
Main Results:
- New Hansen's disease cases are predominantly seen in immigrants from endemic countries.
- Early signs can include asymptomatic macules or patches, or acute inflammatory episodes termed 'reactions'.
- Effective treatments include dapsone, rifampin, clofazimine, thalidomide, and prednisone.
Conclusions:
- Early recognition and treatment of Hansen's disease are vital to avert potentially disabling neurological and ophthalmological complications.
- Physicians in endemic-prone areas like Florida must be vigilant for this disease.
- Referral to specialized Hansen's Disease Centers can aid in management.
Abstract:
The incidence of Hansen's disease has increased with most new cases appearing in California and Florida. The bulk of this increase can be attributed to the immigration of patients from countries where the disease is endemic. Because many immigrants from Caribbean basin countries settle in Florida, it is especially important for physicians here to be able to recognize this disease. An asymptomatic macule or patch may be the first recognizable feature. Alternatively, patients may present with an acute inflammatory episode known as a "reaction". Dapsone, rifampin, clofazimine, thalidomide and prednisone are useful in treatment. With early recognition and treatment, potentially disabling neurological and ophthalmological sequelae can be avoided. Consultation with or referral to either the Miami Regional Hansen's Disease Center or the Gillis W. Long Hansen's Disease Center in Carville, La., may be helpful.